Dahners L E
Division of Orthopaedics, University of North Carolina, Chapel Hill 27599-7055, USA.
J South Orthop Assoc. 1995 Spring;4(1):3-8.
Fractures of the proximal humerus are common, especially in elderly individuals, and are usually classified according to Neer into fractures having one, two, three, or four parts with or without an associated dislocation or an injury splitting the humeral head. This article is intended to assist the surgeon in selecting and using techniques for internal fixation of these fractures. The use of open reduction and internal fixation using plates and screws has become less popular because of the extensive dissection required and the tendency for the plate to impinge. Use of multiple percutaneous pins to fix the humeral head to the shaft (surgical neck) and heavy sutures or wires to reattach the tuberosities is often preferable.
肱骨近端骨折很常见，尤其是在老年人中，通常根据Neer分类为具有一个、两个、三个或四个部分的骨折，伴有或不伴有相关脱位或肱骨头劈裂损伤。本文旨在协助外科医生选择和使用这些骨折的内固定技术。由于需要广泛的解剖以及钢板有撞击的倾向，使用钢板和螺钉进行切开复位内固定已不太受欢迎。使用多根经皮针将肱骨头固定至骨干（外科颈），并用粗缝线或钢丝重新附着结节通常更可取。
