一期关节镜下肱骨髓内钉取出及修复肩袖的临床意义  

Primary removal of intramedullary nail and repair of rotator cuff under arthroscopy

作　　者：马湘毅[1] 潘西庆[1] 李锋[1] 白玉娟[1] 先锋[1] 窦珊珊[2] 郝京霞[3] 王志斐 

机构地区：[1]河北省石家庄市第三医院关节外科,050000 [2]石家庄市第一医院 [3]河北省儿童医院 [4]邢台市宁晋县第三医院

出　　处：《中国骨与关节损伤杂志》2013年第11期1032-1034,共3页Chinese Journal of Bone and Joint Injury

基　　金：2012年石家庄市科学技术研究与发展计划项目(121461533)

摘　　要：目的通过临床病例对照研究观察肩关节镜下取髓内钉同时修复肩袖对肩关节功能的影响。方法将自2007-06—2009-06收治的肱骨干骨折髓内固定术后患者60例,分为实验组(30例)和对照组(30例),实验组采用肩关节镜取出内固定并同时修复肩袖,对照组采用传统的切开方法取出内固定,未对肩袖进行特殊修复。手术前后采用ConstantMurley肩关节功能评分及Neer肩关节功能评分评定肩关节功能。结果随访2年后,两组患者术后Constant-Murley肩关节功能评分及Neer肩关节功能评分与术前比较,差异有统计学意义(P<0.05),对照组6例进行了再次的肩关节镜肩袖修复手术。结论肩关节镜下取髓内钉同时修复肩袖能显著改善术后肩关节功能。Objective To compare postoperative shoulder function between arthroscopic removal of the intramedullary nail and arthmseopic rotator cuff repair and the conventional open procedure. Methods Between Jun. 2007 and Jun. 2009, 60 patients who had underwent surgical treatment for arthroscopic removal of the intramedullary nail were divided into experimental group and control group. Patients of experimental group were treated with an arthroscopie removal of the intramedullary nail and arthroseopic rotator cuff repair. Patients of control group were treated with conventional open procedure. Clinical outcomes were assessed using the Constant-Murley and Neer shoulder seore. Results After 2 years follow-up, the Constant-Murley and Neer shoulder score between the two groups were significantly different （P 〈0.05）. There were 6 patients with rotator cuff tears in the conventional operation group suffered a second operation. Conclusion This study provides evidence that shoulder function could be improved by arthroscopic removal of intrameduUary nail in the humerus compared with the conventional operation.

关 键 词：肱骨干骨折 髓内钉 关节镜下取出 肩袖损伤 

分 类 号：R687.3[医药卫生—骨科学]