肩关节镜下缝线桥技术治疗肱骨大结节骨折的临床研究

发布时间：2018-07-03 05:41

本文选题：肩关节镜 + 缝线桥技术　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的:评价肩关节镜下缝线桥技术治疗肱骨大结节骨折的临床应用价值。方法:收集我院2014年9月至2016年4月采用肩关节镜下缝线桥技术治疗肱骨大结节骨折患者为随访对象。所选病例均采用肩关节镜下缝线桥技术进行治疗,术后患者均复查肩关节X线片,根据患者复查结果,逐渐进行主动锻炼及力量锻炼。术前、术后分别采用Constant-Murley评分、美国肩肘外科医师ASES评分、视觉模拟VAS疼痛评分、加州大学洛杉矶分校UCLA评分评估肩关节功能评估进行统计学分析。术后患侧完全恢复的肩关节活动度与健侧的采用统计学分析相比较。结果:对21例患者进行了肩关节镜下缝线桥技术,共20例患者完成随访,平均随访时间10个月(5—12个月)。术后随访患者均未出现骨折移位或不愈合,固定失效,切口感染等情况。末次随访时肩关节活动度:前屈上举平均活动度为168±7.54°(正常范围150—180°),外旋平均为66.5±4.2°(正常范围50—70°),内旋平均为T6.7±1.66(T4—T12),术后随访肩关节活动度与健侧活动相比,略有差异,但是采用统计学分析后,无统计学差异(P0.05)。Constant-Murley评分平均为93.50±3.24分,ASES评分平均为90.80±4.72分、VAS疼痛评分平均为0.30±0.57分,UCLA评分平均为32.40±1.90分,四种评分术前术后存在统计学差异(P0.05)。结论:肩关节镜下缝线桥技术治疗肱骨大结节骨折,手术创伤小,固定牢靠,特别是小的、粉碎的骨折块,可以有效的分散缝线的剪切力和扭转力,加大固定面积,可以促进愈合,术后不需取出内固定,肩关节功能恢复较好,是一种有效的治疗方法。
[Abstract]:Objective: to evaluate the clinical value of arthroscopic suture bridge in the treatment of humeral tubercle fracture. Methods: from September 2014 to April 2016, patients with humeral tubercle fracture were treated with arthroscopic suture bridge technique. All the selected cases were treated with shoulder arthroscopic suture bridge technique. After operation, the patients were examined with X ray film of shoulder joint. According to the result of reexamination, active exercise and strength exercise were gradually carried out. Before and after operation, Constant-Murley score, ASES score of American shoulder and elbow surgeon, visual analog VAS pain score and UCLA score of UCLA were used to evaluate shoulder function. The range of shoulder motion recovered completely after operation was compared with that of healthy side. Results: a total of 20 patients were followed up for 10 months (5-12 months). There was no fracture displacement or nonunion, fixation failure, incision infection and so on. At the last follow-up, the average range of shoulder motion was 168 卤7.54 掳(normal range 150-180 掳), 66.5 卤4.2 掳(normal range 50-70 掳), and T6.7 卤1.66 (T4-T12). But after statistical analysis, there was no statistical difference (P0.05). Constant-Murley score was 93.50 卤3.24. The average ASES score was 90.80 卤4.72. The average VAS pain score was 0.30 卤0.57. The average UCLA score was 32.40 卤1.90. There was statistical difference between the four scores before and after operation (P0.05). Conclusion: the technique of shoulder arthroscopic suture bridge for the treatment of humeral tuberculous fracture has the advantages of small trauma, reliable fixation, especially small and comminuted fracture, which can effectively disperse the shear force and torsion force of suture and enlarge the fixed area. It can promote healing, no removal of internal fixation, good recovery of shoulder function, is an effective treatment.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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