目的：探讨锁定钢板内固定治疗老年性肱骨近端骨折的临床疗效。方法回顾性分析2007-08至2012-12某院收治的老年性肱骨近端骨折55例资料。 Neer分型：二部分骨折11例，三部分骨折25例，四部分骨折19例，采用有限切开复位锁定钢板内固定治疗，对四部分骨折19例内侧均进行了取自体髂骨植骨。注重锁定钢板固定术后的早期功能锻炼；分析锁定钢板较传统钢板固定治疗老年肱骨近端骨折的优势。结果所有病例均随访6～18个月，平均9个月。骨折愈合时间11～15周，平均13周。根据Neer肩关节功能评分：优17例，良31例，可7例，优良率87．3％。并发伤口脂肪液化伴轻度感染2例，螺丝钉穿出关节面1例，肱骨头轻度内翻1例，肱骨头坏死2例。结论锁定钢板内固定治疗老年性肱骨近端骨折，相比传统内固定方法，损伤小、固定可靠，可以早期进行肩关节功能锻炼，促进功能康复，尤其适合合并骨质疏松的老年骨折患者的治疗。%Objective To study the clinical effects of locking plate internal fixation for treating the senile proximal humeral fracture.Methods The clinical data of 55 patients with senile proximal humeral fracture in this hospital from August 2007 to Decem-ber 2012 were analyzed retrospectively.According to Neer classification system, there were 11 cases of two-part fractures, 25 cases of three-part fractures and 19 cases of four-part fractures.We used limited open reduction with locking plate internal fixation for treat-ment.Self iliac bone graft was used for the 19 cases of four-part fractures.We paid attention to early postoperative functional exercise and analyzed its advantages compared with traditional methods.Results All patients were followed up for 6-18 months ( average 9 months) , the healing time was 11 to 15 weeks ( average 13 weeks) , 17 cases were evaluated as excellent, 31 cases as good and 7 ca-ses as fair according to score of shoulder joint.The excellent and good rate was 87.3%.Two cases had incision fat necrosis with slight infection, 1 case screw penetrating joint surface, 1 case humeral head mild valgus, and 2 cases humeral head osteonecrosis. Conclusions Locking plate internal fixation for treating senile proximal humeral fracture has many advantages compared with tradition-al methods.This method has smaller damage, reliable fixation, allows to make early functional exercises and improves functional recov-ery.It is especially suitable for the senile patients complicated by osteoporosis.
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