目的 探讨肱骨近端内固定锁定系统(PHILOS)接骨板治疗复杂老年肱骨近端骨折的疗效.方法 回顾性分析我院2005年6月~2008年12月应用PHILOS接骨板手术治疗复杂老年肱骨近端骨折27例临床资料,其中男性15例,女性12例;平均年龄74岁(59~83岁).按Neer分型:三部分骨折19例,四部分骨折8例,均有原发性骨质疏松.复位后PHILOS接骨板固定.结果 术后随访8~36个月,平均13个月.骨折全部愈合,2例出现肱骨头坏死.按照Neer肩关节功能评分标准:优6例,良14例,可4例,差3例;优良率74%.结论 应用PHILOS接骨板治疗复杂老年肱骨近端骨折固定可靠,可以早期功能锻炼,术后功能恢复满意,对复杂老年肱骨近端骨折是一种有效的治疗方法.%Objective To summarize the treatment effect of proximal humeral internal locking system( PHILOS ) for complex proximal humeral fractures in old patients. Methods A retrospective study was done on 27 cases of complex proximal humeral fracture treated with PHILOS plate from Jun. 2005 to Dec. 2008, including 15 males and 12 females aged 59-83 years ( average 74 years). According to the Neer classification, 19 cases were three-part fractures, 8 cases were four-part fractures, and all cases were observed primary osteoporosis. A deltoid-pectoral approach was used in all patients and fixed the fracture with PHILOS plate after reduction, the tubercle fragments were sutured with non-absorbable ethibond. Results The follow-up time ranged from 8 to 36 months,with mean of 13 months. All fractures got bone union and humeral head necrosis was observed in 2 cases. By Neer shoulder scoring system, 6 cases were excellent,14 cases were good,4 cases were fair and 3 cases were poor. Conclusion Applying PHILOS plate in treatment of the complex proximal humeral fractures in old patients provides a stable fixation and earlier rehabilitation. It is an effective method for complex proximal humeral fractures in old patients.
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