肱骨近端骨折合并肩袖破裂的发病率及与骨折类型和年龄分布的相关性  

The incidence of rotator cuff tear in proximal humeral fractures and its correlation with fracture type and age distribution

作　　者：庄澄宇[1] 陈哲[1] 宋艳艳[2] 王蕾[1] 徐才祺[3] 陈毓[1] 叶庭均[1] 陈杰[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院骨科,200025 [2]上海交通大学医学院附属瑞金医院统计教研室,200025 [3]上海交通大学附属第六人民医院,200233

出　　处：《中华骨科杂志》2017年第21期1356-1360,共5页Chinese Journal of Orthopaedics

摘　　要：目的评估肱骨近端骨折合并肩袖破裂的发病率及与骨折类型和年龄分布的相关性．方法回顾性分析2014年1月至2016年1月，113例进行外科手术的肱骨近端患者资料，记录患者的年龄、性别、受伤的原因、术前MRI示肩袖全层破裂的情况以及水中探查肩袖损伤及修补情况。计算计比较不同年龄段肱骨近端骨折合并与不合并肩袖损伤的发生率，同时根据Neer分型计算并比较不同骨折类型中肩袖全层破裂的发生率。结果113例患者中有28例（24．8％，28／113）在术中发观存在肩袖全层破裂，且其中21例在术前已经通过MR检查得到诊断。28例肩袖破裂患者的平均为（75．11±10．89）岁，较85例无肩袖破裂患者的平均[（64．68±13．43）岁]大，两者比较筹异有统计学意义，Neer骨折类型分析中，3部分大结节骨折合并肩袖全层破裂的发生率最高，为33．33％（8／54），其次是2部分大结节骨折（26．67％，4／15）和2部分外科颈骨折（17．65％，6／34），4部分骨折中未发现全层破裂。在28例肩袖破裂患者中，24例术前无肩父节疾病或症状，4例有肩关节疾病的病史。结论肱骨近端骨折合并有肩袖破裂的患者约古眩骨近端骨折患者的24．8％；随着年龄的增加，肩袖损伤的比例逐渐升高；肱骨近端骨折Neer分制中3部分大结节骨折常合行肩袖全层破裂。Objective To evaluate the prevalence of lull thickness rotator cuff tear in patients with proximal humeral fractures, and the relationships between different risk factors. Methods Data of 113 patients with proximal humeral fraetures from January 2014 to January 2016 who underwent surgical treatment were retrospectively analyzed. The general characteristics of patients （age, sex, cause of injury） were recorded and the rotator cuff was evaluated preoperatively on MRI and explored intra-operatively. We ealeulated and compared the incidence rate of age, sex in patients with and without rotator cuff tear. And the incidence rate of rotator cuff tear in different types of fracture aecording to Neer classification was calculated. Results The full thickness rotator cuff tear were indentified in 28 patients （24.8%）, and 21 of them had been confirmed by Mill preoperatively. Statistical significant difference was found between patients with rotator euff tear group （average of 75.11 ± 10.89 years oht） and without rotator cuff tear group （64.68±13.43） for the age of the patient. Full thickness rotator cuff tear was most common in Neer 3 CT fracture （33.3%, 8/54）, followed by Neer 2 GT （26.67%, 4/15） and Neer 2 SN （17.65,6/34）, however, no full thickness rotator was found in Neer 4 type fracture. There were 4 patients with total rotator cuff tear who had symptom of shouhter before the operation. The other 24 patients had no symptom of shoulder. Conclusion Patienl age was found as a risk factor for tull thickness rotator cuff tear in hunteral proximal fractures with the rate of 24.8%. Full thiekness rotator cuff tear was most common in Neer 3 GT fraelure.

关 键 词：肩骨折 软组织损伤 发病率 年龄分布 

分 类 号：R687.3[医药卫生—骨科学]