经三角肌小切口双排锚钉缝线桥固定治疗撕脱性肱骨大结节骨折  

Mini open reduction through deltoid-split approach and double-row suture anchor bridge fixation in the treatment of avulsion fracture of humeral greater turberosity

作　　者：白云鹏 邱永敏[1] 丁菊红[1] 沈燕国[1] 王健[1] Bai Yunpeng;Qiu Yongmin;Ding Juhong;Shen Yanguo;Wang Jian(Department of Orthopedics,Pudong New Area People's Hospital,Shanghai,201299,China)

机构地区：[1]上海市浦东新区人民医院骨科,上海201299

出　　处：《生物骨科材料与临床研究》2021年第2期34-37,共4页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：上海市浦东新区卫计委青年科技项目(PW2017B-20);上海市浦东新区卫计委学科带头人培养项目(PWRD2017-08)。

摘　　要：目的探究经三角肌小切口双排锚钉缝线桥技术在治疗撕脱性肱骨大结节骨折中的临床疗效。方法回顾性分析2017年6月至2019年6月上海市浦东新区人民医院收治的24例肱骨大结节撕脱性骨折临床资料。其中,男14例,女10例;年龄35~80岁,平均55.6岁。均采用肩关节外侧小切口劈开三角肌入路,直视下复位,双排锚钉缝线桥技术固定肱骨大结节。术后2周内上肢悬吊带制动下行肩关节"钟摆"样活动,2周后去除外固定开始早期功能锻炼。记录术前、术后末次随访肩关节功能Constant-Murley评分,VAS疼痛视觉模拟评分及肩关节活动范围。结果24例患者术后随访6~24个月,平均14个月。无伤口感染、骨折再移位、锚钉脱出、肩峰撞击等并发症。末次随访肩关节Constant-Murley评分平均(86.6±5.4)分,与术前(38.3±6.7)分比较,差异有统计学意义(P<0.05);其中优18例,良6例,优良率100%。末次随访VAS疼痛视觉模拟评分平均(0.8±0.4)分,与术前(6.1±1.2)分比较,差异有统计学意义(P<0.05)。肩关节活动范围与术前比较,差异均有统计学意义(P<0.05)。结论经三角肌小切口双排锚钉缝线桥固定治疗撕脱性肱骨大结节骨折,手术创伤小,避免二次损伤大结节骨块,固定充分且牢靠,可满足早期功能锻炼,取得满意的临床疗效。Objective To investigate the clinical outcome of mini open reduction through deltoid-split approach and doublerow suture anchor bridge fixation in the treatment of avulsion fracture of humeral greater tuberosity.Methods The clinical data of 24 cases of greater tuberosity fracture who were treated from June 2017 to June 2019 in Pudong New Area People’s Hospital were retrospecively analyzed.There were 14 males and 10 females,aged from 35 to 80 years old,with an average age of 55.6 years old.All cases were treated by the mini deltoid-split approach,open reduction and fixation by double-row suture anchor bridge technique.The injured shoulder were supported by suspension sling and taken pendulum exercises in 2 weeks after operation.After 2 weeks,the external fixation was removed and early functional exercise should be taken.The shoulder function before surgery and at final follow-up were assessed by Constant-Murley score system,the visual analogue pain score(VAS)and the range of shoulder motion were collected.Results All the 24 patients were followed up for 6 to 24 months,with an average of 14 months.There were no complications such as incision infection,fracture redisplacement,suture anchor pullout and subacromial inpingment.The average Constant-Murley score of shoulder was(86.6±5.4)at final follow-up,which was significantly higher than that of pre-operation(38.3±6.7)(P<0.05);18 cases were excellent,6 cases were good,and the excellent and good rate was 100%.The VAS was used to assess pain situation.The mean VAS score was(0.8±0.4)at the final follow-up,which was significantly lower than that of pre-operation(6.1±1.2)(P<0.05).The range of motion of shoulder joint was significantly higher than that before operation(P<0.05).Conclusion This study demonstrates that mini open reduction through deltoid-split approach and double-row suture anchor bridge fixation is a reliable option in the treatment of avulsion fracture of humeral greater tuberosity,which has the advantages of minimal surgical incision,preventing second

关 键 词：肱骨大结节 骨折 带线锚钉 内固定 

分 类 号：R683.41[医药卫生—骨科学]