应用肩峰前外侧小切口治疗肱骨近端骨折

发布时间：2018-06-01 18:42

本文选题：肩骨折 + 肱骨　；参考：《北京大学学报(医学版)》2017年02期

【摘要】：目的:探讨应用肩峰前外侧小切口治疗肱骨近端骨折的可行性、手术方法及疗效。方法:选择2012年1月至2014年10月应用肩峰前外侧小切口入路治疗肱骨近端骨折患者32例,其中男19例、女13例,平均年龄46岁(22~78岁)。骨折原因:摔伤21例、车祸伤11例;按Neer分型:二部分骨折18例、三部分骨折12例、四部分骨折2例。复位骨折后,以肱骨近端解剖型锁定钢板固定,术后开始严格地被动练习肩关节功能。每月复查,待骨折愈合后开始持重练习。结果:32例患者平均随访11个月(3~34个月),骨折全部愈合,无内固定物失效及钢板断裂,无伤口感染病例,肩关节Constant-Murley功能评分平均86分(69~100分)。结论:应用肩峰前外侧小切口入路可以完成对肱骨近端骨折钢板内固定的手术治疗,但是对患者特点和骨折类型以及术者经验要求较高,临床实践中要注意适应征的选择,以达到良好的治疗效果。
[Abstract]:Objective: to explore the feasibility, operative method and curative effect of treating proximal humerus fracture with anterolateral small incision of acromion. Methods: from January 2012 to October 2014, 32 patients with proximal humerus fracture were treated with small anterolateral acromion incision approach, including 19 males and 13 females, with an average age of 46 years or 2278 years. According to Neer classification, there were 18 cases of two-part fracture, 12 cases of three-part fracture and 2 cases of four-part fracture. After reduction, the proximal humerus anatomic locking plate was used to fix the shoulder joint. Monthly review, after the fracture healing began to exercise weight. Results 32 cases were followed up for an average of 11 months, ranging from 3 to 34 months. The fractures were healed, no internal fixation failure and steel plate breakage, and no wound infection. The average Constant-Murley score of shoulder joint was 69 ~ 100 points. Conclusion: the internal fixation of proximal humerus fracture can be completed by using the small anterolateral approach of acromion, but the characteristics and types of fracture and the experience of the operative should be high. In clinical practice, attention should be paid to the choice of adaptive sign. In order to achieve good therapeutic effect.
【作者单位】：北京积水潭医院创伤骨科;
【分类号】：R687.3

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