肱骨近端骨折大结节骨块的形态学分析  

Morphological observation of the greatertuberosity fracture fragments of proximal humerus fracture

作　　者：黄华明 张学军[2] 倪英杰 郭玉冬[2] 王宸[2] HUANG Huaming;ZHANG Xuejun;NI Yingjie;GUO Yudong;WANG Chen(Department of Orthopedic Surgery,Xishan People′s Hospital of Wuxi,Wuxi 214105,Jiangsu,China;Department of Orthopedic Surgery,Zhongda Hospital,School of Medicine,Southeast University,Nanjing 210009,Jiangsu,China)

机构地区：[1]无锡市锡山人民医院骨科,无锡214105 [2]东南大学附属中大医院骨科,南京210009

出　　处：《医学研究与战创伤救治》2023年第7期760-762,共3页Journal of Medical Research & Combat Trauma Care

摘　　要：目的分析肱骨近端骨折后大结节骨折块的形态,以期作为手术治疗的参照。方法回顾性研究2015年1月至2021年12月东南大学附属中大医院骨科收治的269例肱骨近端骨折患者。通过X线及CT二维、三维图像测量肱骨近端骨折后大结节骨折块,分析其形态。结果肱骨近端骨折大结节骨折块形态可归纳为以下类型:单纯大结节骨折块(110例);大结节骨折块连带结节间沟及部分小结节骨块(109例);粉碎性大结节骨折(50例)。其中粉碎性大结节骨折块可分为3种亚型:骨折块有纵向裂隙;骨折块有横向裂隙;完全粉碎。结论肱骨近端骨折大结节骨块主要以单纯大结节骨折块型为主,可为手术治疗肱骨近端骨折提供参考。Objective The purpose of this article is to investigate the morphology of the greater tuberosity fracture fragments and their relative position to humeral shaft in proximal humerus fractures.Methods A retrospective study was undertaken to examine 269 patients admitted from January 2015 to December 2021.X-ray and CT images were used to measure and record the morphology of tuberosity fracture fragments of proximal humerus fracture.We investigated the morphology of the greater tuberosity fracture fragments and their relative position to humeral shaft in proximal humerus fractures,which were used as the standard for the height of the prosthesis.Clinical outcomes were analysed in shoulder hemiarthroplasty for treatment of proximal humerus fractures.Results 269 patients were admitted from January 2015 to December 2021.There were 100 male(average age 72.14 years,21 to 87 years)and 169 female(average age 75.35 years,25-91 years).The morphology of the greater tuberosity fracture fragments were classified into the following types:Type 1,simple greater tuberosity fracture fragment,Type 2,greater tuberosity fracture fragment with intertubercular groove and part of lesser tuberosity fracture fragment,Type 3,comminuted greater tuberosity fracture fragment.Type 1 and 2 fracture fragments were completely reduced,while type 3 reconstruction process was relatively difficult.Conclusion The morphology of the greater tuberosity fracture fragments is diverse.X-ray and CT,especially CT 3-dimensional imaging can provide effective reference for surgical treatment of proximal humerus fractures.

关 键 词：肱骨近端骨折 肱骨大结节 形态学 

分 类 号：R683[医药卫生—骨科学]