Chang Zuhao, Zhang Wei, Tang Peifu, Chen Hua
Department of Orthopedics, Chinese PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Mar 15;35(3):375-380. doi: 10.7507/1002-1892.202009127.
To review the literature about the clinical application and research progress on medial support augmentation of plate osteosynthesis for proximal humeral fractures, and to provide reference for clinical treatment.
The literature concerning medial support augmentation of plate osteosynthesis for proximal humeral fractures in recent years was extensively reviewed, as well as the biomechanical benefit and clinical advantage were analyzed thoroughly.
Medial support augmentation of plate osteosynthesis for proximal humeral fractures is very important, especially in osteoporotic and/or comminuted fractures. Many medial support augmentation methods have been proposed which can be divided into extramedullary support and intramedullary support. It can also be divided into autogenous bone support and allogenic bone support according to the material and source, divided into medial column support, calcar support, and humeral head support according to the support site, and divided into fibular shaft support, femoral head support, anatomic fibula support according to the shape of the augmented fixation. At present, clinical and biomechanical researches show that medial support augmentation is an effective treatment for proximal humeral fractures.
As an important treatment strategy for the treatment of proximal humeral fractures, the medial support augmentation of plate osteosynthesis gets the focus from the biomechanical studies and clinical treatment. However, there are still widespread controversies among orthopedic surgeons regarding the support mode, site, implant shape, and material of medial column support for augmentation of proximal humeral fractures. More high-quality clinical trials and biomechanical researches as well as multi-disciplinary integration, are needed to provide better strategy treatment for the treatment of proximal humeral fractures.
回顾肱骨近端骨折钢板内固定术中内侧支撑增强技术的临床应用及研究进展，为临床治疗提供参考。
广泛查阅近年来关于肱骨近端骨折钢板内固定术中内侧支撑增强技术的文献，并深入分析其生物力学优势和临床优势。
肱骨近端骨折钢板内固定术中的内侧支撑增强技术非常重要，尤其是在骨质疏松性和/或粉碎性骨折中。已提出多种内侧支撑增强方法，可分为髓外支撑和髓内支撑。根据材料和来源还可分为自体骨支撑和异体骨支撑，根据支撑部位可分为内侧柱支撑、距骨支撑和肱骨头支撑，根据增强固定的形状可分为腓骨干支撑、股骨头支撑、解剖型腓骨支撑。目前，临床和生物力学研究表明，内侧支撑增强是治疗肱骨近端骨折的有效方法。
作为治疗肱骨近端骨折的重要治疗策略，钢板内固定术中的内侧支撑增强技术受到生物力学研究和临床治疗的关注。然而，骨科医生在肱骨近端骨折增强的内侧柱支撑的支撑方式、部位、植入物形状和材料等方面仍存在广泛争议。需要更多高质量的临床试验和生物力学研究以及多学科整合，为肱骨近端骨折的治疗提供更好的策略性治疗方法。
