【作者】 高博；

【导师】 韩铭；

【作者基本信息】 山东中医药大学 ， 中医骨伤科学， 2011， 硕士

【摘要】 目的:观察采用肱骨近端解剖锁定钢板治疗不稳定型肱骨外科颈骨折的临床疗效,以便提高肱骨外科颈骨折的治愈率。方法:本研究病例来自山东中医药大学附属医院骨科病房自2007年10月至2010年10月手术治疗且均获完整随访的42例肱骨外科颈骨折患者。其中男性17例,女性25例,年龄最大91岁,最小21岁,平均年龄57.2岁,左侧21例,右侧21例。根据Neer分型标准,Ⅱ型16例、Ⅲ型20例、Ⅳ型6例。术前进行临床诊断及影像学评估,确定手术的时机;术中注意软组织及血管神经的保护;术后指导患者进行系统的康复功能锻炼并采取必要的措施预防并发症的发生。术后一年采用Neer肩关节功能评分标准进行评分,观察疗效。结果:42例患者,优27例,良11例,可3例,差1例,优良率为90.5%。结论:采用肱骨近端解剖锁定钢板是治疗不稳定型肱骨外科颈骨折较为有效的治疗方法;术中注意仔细操作、术后进行系统的功能锻练对肩关节的功能恢复尤为重要。此种治疗方法值得临床应用及进一步的研究。更多还原

【Abstract】 Objective: To observe the clinical curative effect on treating unstable type humerus surgical neck fractures with Proximal humeral anatomy of locking plates therapy, so we can improve the Cure rate of Humerus surgical neck fractures.Methods: We get 42 patients (17 male and 25 female, the oldest is 91 years and the youngest is 21, with average age 57.2) with unstable type humerus surgical neck fractures. The cases were all got surgical treatments (21 cases are from left side and 21 are from right side) and Postoperative follow-up from the orthopedics department of the affiliated hospital of Shandong traditional medicine university, from October 2007 to October 2010. According to the standard of Neer classification, these cases contain 16 cases for the second type, 20 cases for the third type, 6 cases for the fourth type. Before surgery, we made clinical and imaging evaluation, make sure the surgery opportunity. During the operation, we paid more attention for protecting the Soft tissue and Vessels and nerves. After surgery, we gave the Rehabilitation functional exercises and took necessary measures to prevent the complications. We used Neer Rating criteria shoulder function standard of grading to get the score and observe the Curative rate.Results: 42 cases were followed up, excellent in 27, good in 11, fair in3, and poor in 1, 90.5%excellent or good results were obtained.Conclusion: Treating unstable type humerus surgical neck fractures with Proximal humeral anatomy of locking plate therapy is more effective treatment. During the operation, we should operate carefully. And we should give the patients systematic postoperative function training. Both of them are particularly important for the restoration of joint function. This therapy is worthy of clinical application and further research.更多还原