微创经皮内固定治疗老年肱骨近端骨折  

Minimally invasive percutaneous internal fixation foRtreatment of proximal humeral fractures

作　　者：沈庆峰 施翔 范卫星 张舟 SHEN Qing-feng;SHI Xiang;FAN Wei-xing;ZHANG Zhou(Dept of Orthopaedics,the TCM Hospital of Changxing County,Huzhou,Zhejiang 313100,China)

机构地区：[1]长兴县中医院骨科,浙江湖州313100

出　　处：《临床骨科杂志》2022年第4期532-535,共4页Journal of Clinical Orthopaedics

基　　金：浙江省湖州市科技局科技项目(编号:2018GY41)。

摘　　要：目的探讨微创经皮内固定治疗老年NeeRⅢ型肱骨近端骨折的临床疗效。方法采用微创经皮内固定治疗30例老年NeeRⅢ型肱骨近端骨折患者。记录并发症发生情况及肩关节活动度,采用Constant-Murley评分标准评价肩关节功能。结果患者均获得随访,时间12~24个月。骨折均愈合,未发生切口感染、内固定松动、肱骨头坏死、腋神经损伤等并发症。1例发生复位丢失,1例发生肩峰撞击。术后12个月根据Constant-Murley评分标准评价肩关节功能:优10例,良18例,可2例,优良率28/30。末次随访时,肩关节前屈上举85°~175°,后伸20°~45°,外展85°~120°,外旋40°~60°,内旋45°~70°。结论微创经皮内固定治疗老年NeerⅢ型肱骨近端骨折具有复位效果好、安全性高、患者关节功能恢复好等优点,临床疗效满意。Objective To investigate the clinical efficacy of minimally invasive percutaneous internal fixation in the treatment of elderly NeeRtype-Ⅲproximal humeral fractures.Methods The 30 patients of NeeRtpye-Ⅲproximal humeral fractures were treated with minimally invasive percutaneous internal fixation.Complications and shouldeRmobility were recorded.ShouldeRfunction was evaluated with the Constant-Murley scoring criteria.Results All patients were followed up from 12 months to 24 months.All fractures were healed.There were no complications such as incision infection,internal fixation loosening,necrosis of the humeral head,axillary nerve injury and otheRcomplications.Reduction loss occurred in one case and acromion impact occurred in one case.At 12 months afteRsurgery,the function of shouldeRjoint assessed with the Constant-Murley scoring criteria showed that:10 cases were excellent,18 good,2 fair,the excellent-good rate was 28/30.At the last follow-up,the shouldeRrange of motion on the affected side was as follows:anterior-flexion and lift was 85°~175°,posterior-extension 20°~45°,abduction 85°~120°,external rotation 40°~60°,and internal rotation 45°~70°.Conclusions In the treatment of proximal humeral fracture,minimally invasive percutaneous internal fixation has the advantages of good reduction effect,high safety,and good joint function recovery,which has satisfactory clinical efficacy.

关 键 词：肱骨近端骨折 骨折内固定术 微创外科手术 手法复位 老年人 

分 类 号：R683.41[医药卫生—骨科学] R687.32[医药卫生—外科学]