肱骨近端骨折手术治疗中肩袖及三角肌的保护策略  

Protection strategies of rotator cuff and deltoid muscle in the surgical fixation of proximal humerus fractures

作　　者：彭飞[1] 李皓桓[1] 谢威[1] 刘远翔[1] 万震宇[1] 张小龙[1] 唐金明[1] 施家奇 

机构地区：[1]武汉大学人民医院骨关节外科,430060

出　　处：《临床外科杂志》2017年第3期226-229,共4页Journal of Clinical Surgery

摘　　要：目的总结肱骨近端骨折手术治疗过程中肩袖及三角肌保护的经验。方法采用肱骨近端锁定接骨板治疗肱骨近端骨折患者34例,手术采用改良的胸大肌-三角肌入路,应用肱骨近端锁定内固定系统,以加强对肩袖及三角肌的保护。术后定期随访,采用肩关节Constant评分评定肩关节功能。结果术后随访6~20个月(平均11.8个月),34例患者术后及随访肩关节正侧位X线片显示内固定在位,无松动断裂。末次随访Constant肩关节评分优良率94.12%。结论采用肱骨近端锁定接骨板治疗肱骨近端骨折,对肩袖及三角肌的完整保护有助于术后早期功能锻炼,有效改善肩关节功能。Objective To summarize the protection strategies of the rotator cuff and deltoid muscle in the surgical fixation of proximal humerus fractures. Methods 34 patients with proximal humerus fractures who were treated with locking plate were enrolled. There were 12 males and 22 females. The age of patients ranged from 24 to 76 years ,with an average of（50.7 ± 16.7）years. According to the Neer clas- sification, there were 17 cases of type- Ⅱ , 15 cases of type- Ⅲ, and 2 cases of type-Ⅳ. Shoulder joint function was assessed by as assessed by using the Constant scores. Results The follow-up period ranged from 6 to 20 months, with an average of 11.8 months. Postoperative X-ray of the shoulder joint showed that there were no loosening or breakage of the internal fixation. The excellent and good rate of the Constant score at the last follow-up was 94.12%. Conclusion In the treatment of proximal humeral fractures, proximal humeral locking plate can protect the rotator cuff and deltoid muscle, which is helpful to the early exercise and functional improvement of the shoulder joint.

关 键 词：肱骨近端骨折 肱骨近端锁定接骨板 肩袖 术后康复 

分 类 号：R687.3[医药卫生—骨科学]