目的 探讨并分析应用微创切口+锁定解剖钢板治疗肱骨近端骨折的结果和疗效。方法 自2006年5月至2009年10月，运用“T”字形微创切口+锁定解剖钢板的方法，治疗Neer二-四部分骨折共15例，其中男8例，女7例;新鲜骨折13例，陈旧性损伤2例;平地跌倒8例，交通伤3例，其它伤4例;Neer二部分6例，三部分8例，四部分1例;年龄19-82岁，平均45.1岁。结果 15例患者均获得平均18个月随访(12-24月)，其ASES评分为89.1±13.0(55-100)，VAS评分平均为0.9±1.1(0-5)，Constant-Murley评分为88.5±10.1(62-100)，15例患者骨折全部愈合，1例螺钉穿出，1例出现创伤性关节炎，无一例出现肱骨头缺血性坏死。结论 微创切口结合锁定解剖钢板是一种治疗肱骨近端骨折的有效方法，可以减少肌肉、韧带附着点的剥离，较早的促进患肢功能恢复，并较好的保护肱骨近端的血运，有效保证骨折的愈合。
Objective To investigate and analyze the application of minimal invasive incision combined with locking anatomical plate for treatment of proximal humeral fractures.Methods From May 2006 to October 2009,15 patients with proximal humeral fractures (Neer type Ⅱ-Ⅳ) were treated with T-shaped minimal invasive incision and locking anatomical plate including 8 males and 7 females at average age of 45.1 years old (range 19-82 years);13 fresh fractures cases,2 old injuries cases;8 fall on flat cases,3 traffic accidents cases,4 other injuries cases;6 Neer two-part fractures cases,8 Neer three-part fractures cases,1 Neer four-part fractures case.Results 15 patients were followed up for 18 months on average (12-24 months).The mean ASES score was 89.1±13.0 (55-100),mean VAS score was 0.9±1.1 (0-5) and mean Constant-Murley score was 88.5+10.1 (62-100).All fractures healed well in 15 patients and there was no avascular necrosis.Screw piercing occurred in 1 case and there was traumatic arthritis in 1 case.Conclusion Minimal invasive incision combined with locking anatomical plate is an effective method to treat proximal humeral fractures that can reduce injuries of muscle and ligament attachment points,promote functional recovery earlier,protect the blood supply of the proximal humerus and ensure the fracture healing effectively.
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