【摘要】 目的 探讨切开复位肱骨近端内固定锁定系统(proximal humeral internal locking system，PHILOS)治疗老年肱骨近端骨折的疗效。 方法 2008年5月-2009年5月，对22例60岁以上肱骨近端新鲜移位骨折按Neer分型，二部分2例，三部分16例，四部分4例；采用肩前方入路切开复位PHILOS治疗。 结果 22例患者获12～18个月随访，平均14.6个月，采用Constant-Murley评分，优8例，良10例，可3例，差1例，优良率81.4%。 结论 切开复位PHILOS治疗老年肱骨近端骨折疗效肯定。【Abstract】 Objective To discuss the clinical effect of open reduction and internal fixation with the proximal humeral internal locking system (PHILOS) plate in treating elder patients with proximal humeral fracture. Methods From May 2008 to May 2009, we classified 22 cases of fresh displaced proximal humeral fracture according to the Neer classification. All patients were older than 60 years. There were two cases of two-part fracture, 16 cases of three-part fracture and four cases of four-part fracture. The open reduction and internal fixation with PHILOS plate was performed with the anterior deltopectoral approach. Results The 22 patients were followed up for 12 to 18 months with a mean period of 14.6 months. According to Constant-Murley Shoulder Score measurement, eight cases were graded as excellent, 10 good, three fair, and one poor with a excellent and good rate of 81.4%. Conclusion The open reduction and internal fixation with Philos plate is effective in treating elder patients with proximal humeral fracture.
目的 观察后路环形减压治疗胸腰椎爆裂骨折术后2～5年的临床疗效及并发症发生情况。 方法 回顾性分析2007年1月－2011年3月23例胸腰椎椎体爆裂骨折患者资料，23例患者存在骨折压迫硬膜合并神经症状，均予后路环形减压。术后定期随访，采用日本骨科协会评估治疗分数、美国脊髓损伤协会脊髓损伤分级评定临床疗效及神经功能改善情况，通过影像学资料观察脊柱Cobb角变化情况。 结果 23例患者手术顺利，经过2～5年的随访，出现术后脑脊液漏3例，尿路感染5例，经对症处理后好转。 结论 经椎弓根内侧行椎体后壁切除，可良好减压，避免神经挤压继发加重损伤，有利于神经功能恢复。