加长型Philos系统治疗肱骨近端骨折

目的探讨应用加长型Philos系统治疗肱骨近端骨折的的手术方法及疗效。方法回顾性分析2009年1月至2012年12月期间我科同一组医生采用加长型Philos系统治疗肱骨近端骨折17例患者,其中女12例,男5例,平均年龄71岁(62~85岁)。伤后2~5 d实施手术,患者取"沙滩椅位"或仰卧位,选择延长的肱骨近端切口,术中直视下复位骨折,采用加长型Philos钛板螺钉固定。术后即刻,以及术后1、3、6、12个月复查X线片观察骨折愈合情况。结果所有患者术后X线片显示肱骨近端骨折复位满意,钛板螺钉位置良好。随访6~32个月(平均16.8个月),骨折均愈合,无肱骨头坏死、内固定松动断裂及伤口感染等并发症发生。按Neer肩关节功能评分标准进行疗效评价,优10例,良4例,可3例,优良率为82.4%。结论加长型Philos系统具有设计合理、安装相对容易、固定牢靠的优点,是治疗肱骨近端骨折的有效选择之一。

Clinical Effect of the Surgical Treatment of the Proximal Humeral Fractures Using the Long Philos System

Objective To evaluate the clinical effect of the Surgical Treatment of the Proximal Humeral Fractures Using the Long Philos System. Methods A total 17 cases with the proximal humeral fractures from Jun 2009 to Nov 2012 underwent surgical treatment with the long Philos system. The operation were done by one group of experienced trauma surgeon at 2 to 5 days after injury. The patient was positioned in the beach-chair position or supine. The humeral anterolateral approach was used. The skin incision was approximately 15 to 20 cm long,beginning at the coracoid and angled distally to the deltoid tuberosity. then extended along the lateral of the bicep. In the operation,the fracture was reduced and fixed by the long Philos system. The bone union were evaluated for all patients after operation. Results The postoperative radiographs verified good position of plate and screws,with satisfactory fracture reduction and no neurovascular injury（such as axillery nerve and humeral artery）happened. The periods of follow-up were 6 ～32 months of all the patients. No necrosis of humeral head,no delayed union and ununion happened. All the fractures healed in 8 to16 weeks. According to Neer scoring system,the excellent and good rate was 82. 4%. ConclusionThe Long Philos System has anatomical and reasonable design and can be used to treat the fractures of proximal humerus.