解剖重建治疗肩关节脱位急性肱骨头压缩性骨折  

Anatomical reconstruction for acute compression fractures of the humeral articular surface after shoulder dislocation

作　　者：汪喆[1] 彭飞[1] 李建平[1] 李皓桓[1] WANG Zhe;PENG Fei;LI Jianping(Department of Orthopedics,People's Hospital of Wuhan University,Hubei,Wuhan,China)

机构地区：[1]武汉大学人民医院骨科,430060

出　　处：《临床外科杂志》2021年第11期1059-1062,共4页Journal of Clinical Surgery

摘　　要：目的总结解剖重建的方式治疗肩关节脱位导致的急性肱骨头压缩性骨折的手术技巧和经验。方法2017年10月~2019年12月因盂肱关节脱位导致的肱骨头压缩性骨折病人5例(7侧),均通过三角肌-胸大肌入路暴露肩关节,经骨窗反向打压复位,植骨后使用空芯钉支撑塌陷的骨软骨。随后定期随访,采用肩关节Constant-Murley评分系统评价肩关节功能。结果所有病人获得随访,术后随访13~36个月,平均(20.4±8.9)个月,全部病人无内固定失败,骨折全部愈合,无复发性脱位,末次复查时Constant评分82~98分。结论急性肱骨头压缩性骨折的解剖重建是一种安全可靠、效果良好的手术方式,结合早期功能锻炼可获得良好的治疗效果。Objective To summarize the operation techniques and experience of anatomical reconstruction for acute of the humeral head compression fractures.Method From October 2017 to December 2019,5 cases of humeral head compression fracture caused by dislocation of glenohumeral joint(7 side).The shoulders were exposed via deltopectoral approach.The fractures were elevated and allograft bone were filled under the osteochondral,then underpinned with screws.With regular follow-up visits,shoulder function was assessed by Constant-Murley scores.Results The follow-up period ranged from 13 to 36 months[average(20.4±8.9)months].Postoperatively,the sphericity of the humeral head was restored without internal fixation failure.No evidence of collapse,osteonecrosis,or osteoarthritis progression was seen at latest follow-up.Functional results were excellent.Constant score was 82 to 98 at the last review.Conclusion Anatomical reconstruction is a safe and reliable technique to restore humeral head sphericity in patients with glenohumeral joint dislocations with serious acute humeral head defect.

关 键 词：Hill-Sachs损伤 解剖重建 肩关节脱位 空芯钉 

分 类 号：R687.3[医药卫生—骨科学]