自制齿状钩钢板结合热气球技术治疗MutchⅠ或Ⅱ型孤立性肱骨大结节骨折  

Self-made dentation hook plate associated with hot-air balloon technique on treatment of MutchⅠorⅡtype isolated greater tuberosity fractures of humerus

作　　者：魏长宝 芮永军[1] 吴永伟[1] 马运宏[1] 周明[1] 康永强 王亚鹏 刘军[1] WEI Changbao;RUI Yongjun;WU Yongwei;MA Yunhong;ZHOU Ming;KANG Yongqiang;WANG Yapeng;LIU Jun(Department of Orthopedics,Wuxi Ninth People’s Hospital,Suzhou University,Wuxi Jiangsu,214062,P.R.China)

机构地区：[1]苏州大学附属无锡市第九人民院骨科,江苏无锡214062

出　　处：《中国修复重建外科杂志》2020年第9期1120-1124,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨自制齿状钩钢板结合热气球技术治疗MutchⅠ、Ⅱ型孤立性肱骨大结节骨折的临床效果及安全性。方法回顾分析2016年1月—2018年12月收治的15例MutchⅠ、Ⅱ型肱骨大结节骨折患者临床资料。男9例,女6例;年龄29~62岁,平均45.1岁。致伤原因:摔伤9例,交通事故伤6例。MutchⅠ型4例,Ⅱ型11例。合并肩关节前脱位7例。受伤至手术时间2~10 d,平均4.5 d。采用自制齿状钩钢板结合热气球技术复位固定治疗。结果 15例患者均获随访,随访时间8~16个月,平均13.5个月。无切口感染、骨折块复位丢失、骨折延迟愈合或不愈合发生;骨折愈合时间4~8个月,平均6.5个月。1例术后第1天即出现腋神经麻痹症状,予以营养神经治疗,2.5个月后症状消失;3例出现轻度肩峰下撞击,待骨折愈合后提前取出钢板,患者肩关节外展时疼痛及异响消失。末次随访时,采用Costant-Murley评分评价肩关节功能为88~100分,平均96.8分;获优8例,良7例,优良率100%。患者于术后8~16个月二次手术取出钢板,无再骨折发生。结论自制齿状钩钢板结合热气球技术治疗MutchⅠ、Ⅱ型孤立性肱骨大结节骨折安全、固定可靠,可取得满意临床效果。Objective To observe effectivness and safeness of self-made dentation hook plate associated with hotair balloon technique in treating MutchⅠorⅡtype isolated greater tuberosity fractures of humerus.Methods Between January 2016 and December 2018,15 patients with MutchⅠorⅡtype greater tuberosity fractures were treated with selfmade dentation hook plate associated with hot-air balloon technique.There were 9 males and 6 females with an average age of 45.1 years(range,29-62 years).The injury causes included falling injury in 9 patients and traffic accident injury in 6 patients.According to Mutch classification,4 cases were MutchⅠtype and 11 cases were MutchⅡtype.There were 7 cases with anterior dislocation of shoulder.The time from injury to operation was 2-10 days(mean,4.5 days).Results All 15 patients were followed up 8-16 months,with an average of 13.5 months.There was no infection of incision,loss of reduction of fracture block,delayed union or nonunion.The average time of fracture union was 6.5 months(range,4-8 months).One patient had axillary paralysis at 1 day after operation,and was treated with nutritional nerve therapy,the symptoms disappeared after 2.5 months.Three patients had slight subacromial impingement.After fracture healing,the hook plate was taken out in advance,and the pain and abnormal noise disappeared during shoulder abduction.At last follow-up,Costant-Murley score used to evaluate shoulder joint function was 88-100,with an average of 96.8;8 cases were excellent,7 cases were good,and the excellent and good rate was 100%.The internal fixator was removed after 8-16 months after the secondary operation with no re-fracture occurred.Conclusion The self-made dentation hook plate associated with hot-air balloon technique is a safe and reliable method for the treatment of MutchⅠorⅡtype isolated greater tuberosity fracture of humerus.

关 键 词：肱骨大结节 孤立性骨折 齿状钩钢板 热气球技术 

分 类 号：R687.3[医药卫生—骨科学]