关节镜微创治疗陈旧性肱骨大结节撕脱骨折合并肩袖损伤的临床疗效研究  

Arthroscopic-assisted minimally invasive reduction and osteosynthesis of old avulsion fractures of the greater tuberosity with rotator cuff tear

作　　者：陈志超[1] 顾祖超[1] 段鑫[1] 李志力[1] 

机构地区：[1]成都市第一人民医院骨科,610041

出　　处：《中华肩肘外科电子杂志》2016年第3期162-165,共4页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：成都市科技局惠民工程项目资助课题(SF2013-44)

摘　　要：目的：探讨关节镜微创治疗陈旧性肱骨大结节撕脱骨折合并肩袖损伤的临床疗效。方法回顾性分析2011年1月至2013年12月成都市第一人民医院收治的12例陈旧性肱骨大结节撕脱骨折合并肩袖损伤患者在关节镜下行肱骨大结节成形双固定螺钉肩袖修复的治疗方法。12例患者全部获得随访，随访时间6~24个月。按照美国加州洛杉矶大学 UCLA 功能评分标准，术前、术后6个月分别进行评估，观察其疗效。结果患者的美国加州洛杉矶大学 UCLA 功能评分术前为（20.6±5.3）分，术后6个月随访时评分为（31.5±3.6）分，差异有统计学意义（P〈0.05），本组患者无明确的术后并发症。结论关节镜下肱骨大结节成形并肩袖修复是一种微创、疗效好、康复快的治疗方法。Backgroud Old avulsion fracture of the greater tuberosity is a common clinical disease.Patients with no significant dislocation after fresh avulsion fracture of the greater tuberosity usually take conservative treatment,if conservative treatment effect is not ideal or the selection of early treatment method is unreasonable （conservative treatment for displaced fracture）,the fragment tend to displace to posterosuperior of the proximal humerus,thus may cause malunion of greater tuberosity,lead to subacromial impingement and rotator cuff injury.All these pathological factors can often lead to pain and limited activity of the shoulder.Now conservative treatment is more often used for pain and restricted movement of the shoulder after avulsion fracture of the greater tuberosity, however,the effect is not ideal.From January 201 1 to December 2013,12 cases of avulsion fracture of the greater tuberosity with rotator cuff tear received arthroscopic-assisted minimally invasive reduction and osteosynthesis in Chengdu First People′s Hospital and obtained ideal clinical effect. Methods （1 ）General data.From January 201 1 to December 2013,12 patients with old avulsion fractures of the greater tuberosity with rotator cuff tear received arthroscopic treatment,including 7 males and 5 females;aged from 25 to 62 years old,the average age was 40.8 years old;courses of the disease were 1-1 5 years.Pathogenesis： previous trauma caused avulsion fracture of the greater tuberosity,5 cases combined with shoulder joint dislocation, there was no case of recurrent dislocation.Of all the 12 patients,2 cases were professional athletes,10 cases were not.All patients received preoperative X-ray,MRI examinations and all patients had different degrees of malunion of the greater tuberosity, mainly as the superior displacement of avulsion fragment of the greater＆amp;nbsp;tuberosity,among them 2 cases with free bone fragment under the acromion,type Ⅲacromion were found in 4 cases.All patients had different degrees of rotator cuff inju

关 键 词：陈旧性肱骨大结节撕脱骨折 肩袖 关节镜 

分 类 号：R687[医药卫生—骨科学]