肱骨近端骨折锁定钢板内固定术后螺钉穿出的影响因素及处理研究进展  

Progress in research on causes and management of screw perforation after locking plate fixation of proximal humerus fracture

作　　者：汪秋柯 张明[2] 陈云丰[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233 [2]华中科技大学同济医学院附属普爱医院骨科,武汉430030

出　　处：《中华创伤骨科杂志》2017年第7期641-644,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：肱骨近端骨折是临床常见的上肢骨折，其发生率大约占全身所有骨折的4％～5％。目前临床上常采用锁定钢板对移位的肱骨近端骨折进行内固定，但锁定钢板内固定术后会出现许多并发症，其中锁定螺钉穿出肱骨头是发生率最高的并发症，同时也是引起再手术最常见的原因。穿出肱骨头的螺钉易造成肩胛盂的磨损，并导致剧烈的疼痛。因此如何有效地预防术后螺钉穿出，是骨科医生采用锁定钢板技术治疗肱骨近端骨折时不可回避的问题。本文就目前有关肱骨近端骨折锁定钢板固定后螺钉穿出的相关研究作一综述。Proximal humerus fractures are clinically common upper limb injury, accounting for about 4% to 5% of all human fractures. At present, displaced proximal humerus fractures are often treated by locking plate fixation, but complications may follow. Of them, a locking screw piercing the humeral head has the highest incidence and is thus the most common reason for surgery. Such a screw tends to cause claws of the glenoid cavity, leading to severe pain. Therefore, it is an unavoidable challenge how to effectively prevent postoperative screw piercing for orthopedic surgeons who use locking plating to treat proximal humerus fractures. In this paper, the progress in research will be reviewed on the causes and management of screw perforation after locking plate fixation of proximal humerus fracture.

关 键 词：肩关节 骨折固定术 内 骨钉 原因分析 

分 类 号：R687.3[医药卫生—骨科学]