三角穿插紧锁模式的手术方法处理肱骨颈骨折65例  

作　　者：赵学仁[1] 魏永鹏[1] 袁坤生 徐光云[1] 

机构地区：[1]云南省保山市第二人民医院、武警保山边防支队卫生队678000

出　　处：《中华临床医学杂志》2005年第8期39-40,共2页Chinese Journal of Clinical Practical Medicine

摘　　要：目的 要求复位完整，固定牢靠，能够满足早期进行功能锻炼的要求、而且不容易移位，能够有效地防止术后过久制动性强直肩。方法 （1）选择肱骨解剖颈、外科颈上骨折并完全性移位病例65例；（2）大关节常规手术暴露骨折断面；（3）经骨断面的髓腔向肱骨顶端钻一个孔；（4）经肱骨干粗隆结节内外侧面各钻两个孔贯穿于髓腔；（5）在该三孔内从下至上经髓腔穿插双根钢丝（即：下两孔各穿入一根钢丝头，上一孔共穿出两根钢丝头），穿好后，一边复位、一边扎紧钢丝，构成一个“三孔、三角、双环穿插紧锁立体模式”。结果 由于术中解剖复位，固定牢靠，术后不容易滑脱，可以早期进行功能锻炼，骨愈合进展快，我们实施的65例中没有出现过骨不连、骨折线错位、强直肩等并发症。结论 “三孔、三角、双环穿插紧锁立体模式”的手术方法有四个优点：（1）解剖复位；（2）固定牢靠；（3）手术损伤相对较小；（4）固定材料细小、隐蔽、不超过上关节面、不影响近期和远期的关节运动。综合之下，可以有临床应用价值。Objective The request resets the integrity,fixed and finn and reliable,can satisfy the request of carry on the function in early days, and not easy move,lead after can prevent from tile availably long make to move sex strong keep the shoulder.Methods （1） the choice bone dissects the neck, the surgery neck bone fracture to combine the completeness to move a case 65 example; （2） the toll - gate stanza normal regulations surgical operation exposes the bone fracture cross section; （3）bore a the bore toward the bone top through the of the bone cross section; （4）is each to drill two bores to pierce through through the outside on the side inside the stanza ot the tramework ot thick knot in the; （5）under those three bores inside from the supremacy was add by the a pair of steel wire（namnely：The next two boreses are each to wear to go into a steel wire head, ascending a bore to wear two steel wires of head totally）, wear good after, reset simultaneously and fie up fast the steel wire simultaneously,constitute a “three bores,triangles,a wreaths add to lock the stereoscopic mode tighdy” .Results Because the dissection in reset, fixed and finn and reliable, the slips to take off after is not easy, can carry on the function in early days, the bone matched to make much way more, we carry out of 65 example in did not appear the bone not to connect , wrong of the bone fracture line, strong keep the shouldr etc. complications. Conclusion The surgical operation method of“ three bores, triangles, a wreaths add to lock the stereoscopic mode tightly”contain four advantages： （1）dissect ot reset ; （2）fixedly finn and reliable; （3）the surgical operation harm is opposite smaller; （4） fixedly the material is small,concealment,not over top the joint face,not affect to exercise with the joint of the forward in the near future. Comprehensive under, can have the clinical application value.

关 键 词：三孔三角双环模式 手术方法 肱骨颈 

分 类 号：R68[医药卫生—骨科学]