手法整复结合经皮钢板内固定治疗肱骨近端骨折的疗效观察

摘要

目的：探讨术前手法整复结合经皮微创钢板固定治疗肱骨近端骨折的疗效及其适应证。方法回顾性分析2012年6月至2015年6月32例采用术前手法整复结合经皮微创钢板内固定治疗肱骨近端骨折患者的临床资料。结果32例患者平均手术时间45 min，术中出血量平均100ml。术后复查X线片提示骨折复位满意，内固定位置良好。32例患者均获随访，时间9~12个月，平均10.4个月。骨折愈合时间为术后9~12周，根据Neer评分系统评价，优14例、良14例、可3例、差1例，优良率88%，未发现肱骨头坏死病例。结论手法整复结合经皮钢板微创内固定治疗肱骨近端骨折，减少手术创伤和对骨折端血运的破坏，有利于肩关节功能恢复。%ObjectiveTo explore the clinical effects and indications of minimally invasive percutaneous plate fixation combined with close manipulative reduction for the treatment of proximal humeral fractures.MethodsWe retrospectively analyzed the clinical data of 32 patients with proximal humerus fractures treated by percutaneous minimally invasive plate fixation combined with manipulation reset before operation. The clinical efficacy was evaluated according to the Neer’s scoring systems.Resultsthe average surgical time was 45minutes and average blood loss was 100ml, The average follow-up was 10.4months(from9 to 12months). Postoperative review of X-ray showed fracture reduction is satisfied,the position of fixation is good.The healing time of frature was 9 to 12weeks postoperatively,for the 32 cases,No complications were found.The postoperative Neer’s score was excellent in 14 cases,good in 14 cases,fair in three cases,bad in one case.The rate of excellent-to-good was 88%.Conculsion The close manipulative reduction combined with minimally invasive percutaneous plate fixation is a better choice for fixation of proximal humerus fractures. This method is better than conventional treatment in these aspects such as shorter incision,less disturbance of the blood supply and more stable fixation of the fracture,it is benefical for functional rehabilitation of shoulder.