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1、提要目的:从治疗肱骨外科颈骨折的各种内固定方法中选择目前临床应用较广泛的锁定钢板进行临床观察和研究,总结其在治疗中的优缺点,以期对临床治疗时内固定物的选择提供帮助。方法:2009年09月~2011年10月35例肱骨近端锁定钢板治疗肱骨外科颈骨折患者,年龄24~88岁,平均59岁,男13例,女22例,左侧17例,右侧18例;5例为运动伤,16例为交通伤,14例为摔伤;按照Neer分型法,NeerⅡ骨折15例,NeerⅢ骨折20例。所有35例均采用手术切开复位肱骨近端锁定钢板内固定治疗,术后早期指导病人进行肩关节功能锻炼,术后9个月采用
2、Neer评分系统对患者来进行手术治疗后疗效的评定。结果:本组35例病人均获得随访,随访时间6~20个月,平均随访时间9.5个月。骨折全部骨性愈合,愈合时间为4~10周,平均6个周。所用病例均无刀口感染、神经血管损伤、钢板断裂及螺钉松动、切出、骨折不愈合等并发症发生。按照Neer评分系统进行骨折治疗后疗效评定,关节功能优良率为94.29%。结论:肱骨近端锁定钢板能够为骨折断端提供坚强的稳定,同时减少对骨折端血运的破坏,允许患者早期进行功能锻炼,是治疗肱骨外科颈骨折的一种理想内固定材料。关键词肱骨近端锁定钢板;肱骨外科颈骨折;肩关节;功
3、能锻炼LockingplatefortreatmentofhumeralsurgicalneckfracturestoNeerⅡ、ⅢclinicalefficacySpeciality:ClinicsforChinesescienceAuthor:LiHaishengTutor:prof.XieJinAbstractObjective:fromthetreatmentofneckfracturesofthehumerussurgeryinthechoiceinthecurrentfixedmethodwithextensivecli
4、nicalapplicationoflockingplatesintheclinicalobservationandresearch,andtosumuptheinthetreatmentofadvantagesanddisadvantages,soastowhentheclinicaltreatmentofinternalfixationofthechoicetoprovidehelp.Methods:sep2009toOctober2011,35patientsproximalhumerallockingplateinsurgi
5、caltreatmentofpatientswithfractureofthehumerusneck,age24to88years,onaverage,61yearsold,male13cases,female22cases,left17cases,right18cases).5casesofsportsinjury,16casesoftrafficinjury,14casesoffall;Neerpointsaccordingtothetypemethod,NeerⅡfracturesin15cases,NeerⅢfracture
6、20cases.All35caseswereopenreductionbyoperationproximalhumerallockingplatefixationtreatment,earlypostoperativeguidepatientexerciseshoulderfunction,afterninemonthsofpatientswithNeerscoringsystemtoaftertheevaluationofsurgicaltreatmenteffect.Results:allpatientswereobtained
7、for35caseswerefollowedup6~20monthstime,theaveragefollow-upperiodwas9.5months.Allosseoushealingfracture,healingtimefor4~10weeks,andtheaveragesixweeks.Thecaseswerenowoundinfection,nervedamage,steelplatefractureandbloodvesselsscrewloose,cutout,theheadofthehumerusnecrosisc
8、omplications.AccordingtoNeerratingsystemafterfracturescurativeeffectevaluation,jointfunctionwas94.29%.Conclusion:thep