医学研究与教育 ›› 2019, Vol. 36 ›› Issue (1): 24-27.DOI: 10.3969/j.issn.1674-490X.2019.01.005

• 临床医学 • 上一篇    下一篇

肱骨大结节锁定钢板联合肩峰成形术治疗肱骨大结节骨折

韩子焘1,范卜方1,肖异星1,张卫其1,马战备2   

  1. 1.承德医学院研究生学院, 河北 承德 067000;
    2.保定市第一中心医院骨科, 河北 保定 071000
  • 收稿日期:2018-11-16 出版日期:2019-02-25 发布日期:2019-02-25
  • 通讯作者: 马战备(1971—),男,河北保定人,主任医师,硕士,硕士生导师,主要从事创伤骨科、关节外科、脊柱外科及显微外科的基础及临床研究。E-maill: mzb7101@126.com
  • 作者简介:韩子焘(1990—),男,河北保定人,医师,在读硕士,主要从事创伤骨科治疗及科研。

  • Received:2018-11-16 Online:2019-02-25 Published:2019-02-25

摘要: 目的 探讨肱骨大结节锁定钢板联合肩峰成形术治疗肱骨大结节骨折的临床疗效。方法 回顾性分析18例肱骨大结节骨折采用肱骨大结节锁定钢板行切开复位内固定术,同时行肩峰成形术患者的临床资料及随访资料。使用Neer评分标准评估肩关节功能恢复情况。X线片随访观察骨折愈合情况。结果 术后患者手术切口均为Ⅰ期愈合,18例患者均获术后随访,术后随访6~18个月,平均12.5个月,所有患者在复查后显示均达到骨性愈合。无钢板、螺钉断裂、松动,未出现骨折的延迟愈合、不愈合,无肩峰撞击征等并发症发生。术后6个月随访时,所有患者肩关节外展、上举活动未见明显受限,并且大结节部、肩峰部无自觉疼痛及压痛。Neer评分总评分>90分为优,15例;80~89分为良,3例;70~79分为可,0例;<70分为差,0例。优良率为100%。结论 肱骨大结节骨折采用肱骨大结节锁定钢板内固定的同时行肩峰成形术,可有效预防术后发生肩峰下撞击综合征,有利于肩关节功能的恢复。

关键词: 肱骨大结节骨折, 锁定钢板, 肩峰成形术

Abstract: Objective To explore the locking plate and acromioplasty in the treatment of greater tuberosity fractures of humerus. Methods 18 cases with fractures of greater tuberosity of humerus treated with locking plate and acromioplasty were retrospectively analyzed. Neer standard was applied to evaluate the recovery of shoulder function, and the X-ray was carried to observe the fracture healing. Results The incisions of all the cases were healed by first intention. All 18 patients were followed up for an average period of 12.5 months(6-18 months)and all patients gained bone union without internal fixation breakage, looseness, shoulder peak impingement syndrome. In the 6-month follow-ups after operation, the shoulder joints of the patients lifting and outstretch were not limited, the patients had not any pain and tenderness in shoulder joints. The functional recovery of shoulder joints on the basis of Neer scoring system was: excellent in 15, good in 3, fair in 0, poor in 0. The excellent and good rate was 100%.Conclusion Using locking plate and acromioplasty in the treatment of greater tuberosity fractures of humerus is an effective technique to prevent shoulder peak impingement syndrome after surgery, at the same time it can promote shoulder joint function recovery.

Key words: greater tuberosity fractures of humerus, locking plate, acromioplasty

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