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1、TreatmentofProximalHumerusFractures肱骨近端骨折的治疗现状Summary:Themajorityofproximalhumerusfracturesaretreatednonoperativelywithgoodfunctionalresults.Multipleoptionsexistfortreatingdisplacedfractures,withoutaclearadvantageofanyonemethodforagivenfracturetype.Goalsincludeanadequatereductionan
2、dstablefixationtoinitiateearlymotionandrehabilitation.Decision-makingshouldbebasedonpatientandinjuryspecificsandsurgeon’sexperience.Varioustypesoffixation,includingplates,nails,orpercutaneouspins,canmaintainsufficientstabilitytopromoteshouldermobilityandfunction.Anyofthesemethodswi
3、llhavefewcomplicationswhenundertakenwithappropriatepatientselectionandcarefulsurgicaltechnique.Preliminaryresultsoflockingplatesintheproximalhumerussuggestthatthisisafavorabletreatmentoptionfordisplaced,comminutedproximalhumerusfractures,whichcompareswellwithestablishedmethods.Lock
4、edplatingmayimprovefracturestabilityinsomecomplexpatternsandfacilitateearlyrehabilitation.Itispossiblethatsomefracturespreviouslytreatedwithhemiarthroplastymaybemanagedsuccessfullywithlockingplates.Prospectivestudytoassessthecomplications,outcomes,andcosteffectivenessofnonoperative
5、managementcomparedtovarioussurgicaltreatmentoptionsiswarranted.大多数肱骨近端骨折采用非手术治疗常能获得良好的功能疗效。对移位骨折治疗存在多种治疗选择，对于某个特定的骨折而言，没有一种方法明显优越于另外一种方法。治疗目标包括充分的复位及稳定的固定以早期活动和康复。治疗决策的制定应该基于患者、损伤特点和外科医生的经验与喜好。不同类型的固定，包括钢板、髓内钉或经皮穿针，能保持骨折端的充分稳定以促进肩关节的活动和功能。当选择合适的病例和进行精心的外科治疗，这些方法很少发生并发症。早期疗效显示，肱骨近端锁
6、定钢板是治疗移位粉碎肱骨近端骨折的一个较好的方法，与其他治疗方法相比疗效满意。在一些复杂病例中，锁定钢板能改善骨折的稳定性，有利于早期的术后康复。一些以前需要行半关节置换的骨折可能通过锁定钢板成功治愈。应当进行非手术疗法和各种手术疗法的关于并发症、疗效和花费－疗效比的前瞻性研究。KeyWords:proximalhumerusfracture,humerusnail,lockingplate,Shoulder关键词：肱骨近端骨折，肱骨髓内钉，锁定钢板，肩关节INTRODUCTION介绍Proximalhumerusfracturesoccurinaduald
7、istribution.Youngpeoplesustaintheseinjuriesinfallsandhigh-energyaccidents,whereasthoseolderthan50yearsoldexperiencethesefractureswithincreasedincidenceastheyage.1,2Aboutthreefourthsofproximalhumerusfracturesoccurinindividualsolderthan60yearsold,withanoccurrence3timesmoreofteninwome
8、nthaninmen.1,3Asthepopulat
