骨折论文 (19).doc

骨折论文(19)
肱骨近端复杂骨折的治疗策略
作者:常山,刘战立,严小虎,余鹏,昝安全,林炎水作者单位:成都医学院第一附属医院骨科,四川成都 610500
【摘要】目的探讨肱骨近端复杂骨折的合理治疗策略,明确治疗方法和具体治疗手段。方法回顾总结32 例肱骨近端复杂骨折病例资料。按Neer四部分骨折分类:一或二部分骨折8 例采用保守治疗,18 例〔三部分骨折14 例(其中4 例伴肩关节脱位并有3 例合并臂丛神经损伤)、四部分骨折4 例〕采用切开复位解剖型LC DCP钢板内固定,6 例(四部分骨折伴脱位)采用人工肱骨头假体置换术。结果 32 例均获随访,时间6~36个月,平均16个月。Constant Functional ,总体优良率75%。无一例肱骨头坏死和关节脱位发生。结论对于肱骨近端复杂骨折只要根据骨折具体情况严格分型并选用合理治疗手段,术中充分保留肱骨头血供,有效修复肩袖和大小结节,坚强骨折内固定,尽早合理的关节功能锻炼,可以达到满意的治疗效果。
【关键词】肱骨近端骨折;肩脱位;骨折内固定;肱骨头置换
The Treatment Strategy of plex Proximal Humerus Fractures CHANG Shan,LIU Zhan li,YAN Xiao hu,et al (Department of Orthopaedics,The First Hospital of Chengdu Medical College,Chengdu 610500,China)
Abstract:Objective To investigate the effective treatment strategy for plex proximal humerus fractures
,select the better and appropriate treatment 32 cases of plicated proximal humerus fractures were retrospectively on NEER system,8 cases〔One or Two parts lesion〕were treated by closed reduction,18 cases,which included 4 cases Four parts lesion and 14 cases Three parts lesion〔4 cases were itant with irreducible shoulder dislocation and brachiplex injury〕 were reduced openly and fixed internally with anatomy shaped LC DCP cases〔Four parts lesion be itant with irreducible shoulder dislocation〕 were treated with prosthetic humeral head replacement 32 c