Abstract：
OBJECTIVE: To explore clinical effect of allogeneic peroneal bone marrow support combined with plate internal fixation in treating Neer type Ⅳproximal humeral fractures.
METHODS: From December 2017 to December 2020,12 patients with Neer type Ⅳ proximal humeral fractures were treated with allogeneic peroneal bone marrow support combined with plate internal fixation,including 7 males and 5 females,aged from 56 to 78 years old;the time from injury to operation ranged from 1 to7 days. Operative time,fracture healing time and complications during follow-up were observed,and clinical efficacy was evaluated by Constant-Murley score at the latest follow-up.
RESULTS: All patients were obtained follow up for 20 to 29 months. All patients got bone healing and incisicons were healed at stageⅠ,operative time ranged from 95 to 138 min,blood loss ranged from 210 to 275 ml,fracture healing time ranged from 14 to 18 weeks. Two patients occurred postoperative shoulder stiffness and recovered after 2 weeks of passive exercise. There were no complications such as infection,poor wound healing,and failure (fracture and loosening) of internal fixators occurred. Constant-Murley shoulder function score ranged from 69 to 89 at the latest follow up,2 patients got excellent results,9 good and 1 fair.
CONCLUSIONS: The application of allogeneic fibular bone marrow placement could provide effective support for medial humerus,which is conducive to assisting reduction of fracture end,reducing occurrence of internal fixation failure caused by collapse of humerus head and screw perforation,and significantly improving function of shoulder joint.
METHODS: From December 2017 to December 2020,12 patients with Neer type Ⅳ proximal humeral fractures were treated with allogeneic peroneal bone marrow support combined with plate internal fixation,including 7 males and 5 females,aged from 56 to 78 years old;the time from injury to operation ranged from 1 to7 days. Operative time,fracture healing time and complications during follow-up were observed,and clinical efficacy was evaluated by Constant-Murley score at the latest follow-up.
RESULTS: All patients were obtained follow up for 20 to 29 months. All patients got bone healing and incisicons were healed at stageⅠ,operative time ranged from 95 to 138 min,blood loss ranged from 210 to 275 ml,fracture healing time ranged from 14 to 18 weeks. Two patients occurred postoperative shoulder stiffness and recovered after 2 weeks of passive exercise. There were no complications such as infection,poor wound healing,and failure (fracture and loosening) of internal fixators occurred. Constant-Murley shoulder function score ranged from 69 to 89 at the latest follow up,2 patients got excellent results,9 good and 1 fair.
CONCLUSIONS: The application of allogeneic fibular bone marrow placement could provide effective support for medial humerus,which is conducive to assisting reduction of fracture end,reducing occurrence of internal fixation failure caused by collapse of humerus head and screw perforation,and significantly improving function of shoulder joint.
摘要：
目的：探讨同种异体腓骨骨髓支持联合钢板内固定治疗NeerⅣ型肱骨近端骨折的临床疗效。
方法：2017年12月至2020年12月，采用同种异体腓骨骨髓支持联合钢板内固定治疗NeerⅣ型肱骨近端骨折12例，包括7名男性和5名女性，年龄在56至78岁之间；从受伤到手术的时间为1至7天。手术时间,随访期间观察骨折愈合时间及并发症,并在最新随访时通过Constant-Murley评分评估临床疗效。
结果：所有患者均获得20~29个月的随访。所有患者骨愈合，切口Ⅰ期愈合，手术时间95~138min,失血量从210到275毫升，骨折愈合时间为14～18周。2例患者术后出现肩关节僵硬,经2周被动运动后恢复。没有出现感染等并发症,伤口愈合不良,内固定器失效(断裂和松动)。最近一次随访时，Constant-Murley肩关节功能评分为69至89分，2名患者获得了优异的效果，9个好，1个公平。
结论：同种异体腓骨骨髓置入术可以为肱骨内侧提供有效的支持，有利于辅助骨折端复位，减少肱骨头塌陷和螺钉穿孔引起的内固定失败的发生，显著改善肩关节功能。
方法：2017年12月至2020年12月，采用同种异体腓骨骨髓支持联合钢板内固定治疗NeerⅣ型肱骨近端骨折12例，包括7名男性和5名女性，年龄在56至78岁之间；从受伤到手术的时间为1至7天。手术时间,随访期间观察骨折愈合时间及并发症,并在最新随访时通过Constant-Murley评分评估临床疗效。
结果：所有患者均获得20~29个月的随访。所有患者骨愈合，切口Ⅰ期愈合，手术时间95~138min,失血量从210到275毫升，骨折愈合时间为14～18周。2例患者术后出现肩关节僵硬,经2周被动运动后恢复。没有出现感染等并发症,伤口愈合不良,内固定器失效(断裂和松动)。最近一次随访时，Constant-Murley肩关节功能评分为69至89分，2名患者获得了优异的效果，9个好，1个公平。
结论：同种异体腓骨骨髓置入术可以为肱骨内侧提供有效的支持，有利于辅助骨折端复位，减少肱骨头塌陷和螺钉穿孔引起的内固定失败的发生，显著改善肩关节功能。
