难复性肱骨近端骨折脱位的手术治疗  

Operative treatment of the irreducible proximal humerus fracture and dislocation

作　　者：魏世隽[1] 韩芳[1] 陈庄洪[1] 黄卫兵[1] 

机构地区：[1]广州军区武汉总医院骨科,430070

出　　处：《临床外科杂志》2006年第10期660-661,共2页Journal of Clinical Surgery

摘　　要：目的 探讨难复性肱骨近端骨折脱位的合理手术治疗，以提高疗效。方法 回顾性总结27例难复性肱骨近端骨折脱位病例资料。按NEER分型，两部分骨折脱位16例行切开复位T形钢板或三叶草钢板内固定，三部分骨折脱位11例行切开复位克氏针张力带内固定，术中采用可吸收缝线修补撕裂的肩袖及关节囊，术后早期功能锻炼。结果 27例均获随访，时间12～59个月，平均29个月。疗效评价标准参照Constant—Murley评定方法，优良率达85．2％。结论 对于难复性肱骨近端骨折脱位，保护局部血运甚为重要，术中采用间接复位技术、合理选择简单有效的内固定、充分保护软组织及修复肩袖等原则的应用对于术后功能恢复及预防相关并发症十分重要。Objective To investigate the minimally invasive operative treatment for the irreducible proximal humerus fracture and dislocation and how to elevate the effection of treatment. Meth- otis 27 cases of the irreducible proximal humerus fracture and dislocation were collected. Base on NEER system, 16 cases of the two- part lesion were reduced openly and fixed internally with T - shaped plate or blade plate. 11 cases of the three - part lesion were reduced openly and fixed internally with Kirschner pin and tension band, the lacerated rotator cuff and capsule were repaired by absorbable suture, early rehabili- tation was done. Results 27 eases were followed - up,at a mean follow- up of 29 months（ 12 to 59）. According to Constant- Murley evaluation, excellent and good rate was 85.2 %. Conclusion The key of treatment of the irreducible proximal humerus fracture and dislocation is protecting the vascular supply of the humeral head. Indrect reduction and simple effective fixation and protecting soft tissue and repairing rotator cuff should be used for such this lesion.

关 键 词：肱骨骨折 近端 骨折内固定术 外科手术 

分 类 号：R687.3[医药卫生—骨科学]