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中文摘要：
目的分析肱骨近端锁定内固定系统(proximal humerus internal locking system,PHILOS)中肱骨头螺钉的分布。讨论该固定系统应用中存在的不足。方法 2007年12月至2014年8月,接受PHILOS治疗的41例肱骨近端骨折患者,其中男性15例,女性26例,平均年龄67.7岁(42~89岁)。进行术前健侧肩关节CT测量。测量指标为肱骨头螺钉的理想中心分布线(标记为a)与实际中心分布线(标记为a′)的夹角α。计算其范围及平均值。结果 a′线与冠状面的夹角均小于a线与冠状面的夹角,即a线比a′线更远离冠状面。a线与a′线的夹角α范围为0°~54.3°,平均为20.8°。结论 PHILOS治疗肱骨近端骨折时,螺钉在肱骨头内的分布是整体偏向前方,存在固定螺钉在肱骨头内分布不均匀的现象,有进一步改良空间。
英文摘要：
Background Proximal humerus fracture is one of the fractures that easily occur in human body .It is a fracture around joints so there are specific treatment ways .As the aggravation of aging society ,the osteoporosis population is getting larger .Osteoporosis has become an important issue in the traumatic orthopedics treatment .How to increase the stability of fixation in osteoporosis fracture and how to make sure stability of the bony union in fracture are becoming challenges for traumatic orthopedists .Proximal humerus fracture is one kind of osteoporosis fractures .Proximal Humerus Internal Locking System (PHILOS) has a stable angulation of screws locking as well as assembly of multi‐directions of screws inside the humerus heads .These characteristics increase the stability of fixation and lead to the wide clinical application .This research analyze the humerus head screws distribution in proximal humerus fracture treated by PHILOS .Methods General data:inclusion criteria of cases :(1 ) proximal humerus fracture;(2 ) CT on the shoulder joints before operation;(3) accept the PHILOS operation .From December 2007 to August 2014 ,41 patients who reached the above‐mentioned criteria were selected as the study subjectives .They were patients with fresh fractures and 15 were males and 26 were females .And their average age was 67 .7 years old (from 42‐89 years old) .All patients should have CT of the shoulder joints before the operation .They will get general anesthesia and the operation position is beach chair position .The incision will be performed from the deltopectoral approach .PHILOS from Synthes is selected as the internal fixation device .Date measurements :The contralateral shoulder joint cross section on the CT was selected as the measurement data .The measurement index was the included angle α between the ideal center distribution lines in the humeus head screw s (mark as"a") and the real center distribution line (mark as "a′") .Line a is the perpendicular line of humerus head ,line a′is t
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