[1]秦虎 王云华＊ 何斌 王伯尧.星型钢板小切口治疗肱骨大结节骨折[J].中国微创外科杂志,2014,14(12):1119-1134.
　Qin Hu,Wang Yunhua,He Bin,et al.Application of Star Plate and Small Incision for the Treatment of Greater Tuberosity Fractures[J].Chinese Journal of Minimally Invasive Surgery,2014,14(12):1119-1134.
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星型钢板小切口治疗肱骨大结节骨折()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
14
期数:
2014年12期
页码:
1119-1134
栏目:
临床研究
出版日期:
2014-12-20

文章信息/Info

Title:
Application of Star Plate and Small Incision for the Treatment of Greater Tuberosity Fractures
作者:
秦虎 王云华＊ 何斌 王伯尧
南京医科大学第二附属医院骨科，南京210011
Author(s):
Qin Hu;  Wang Yunhua;  He Bin;  et al.
Department of Orthopedics, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
关键词:
肱骨大结节骨折; 星型钢板; 小切口; 内固定
Keywords:
Fracture of greater tubercle; Star plate; Small incision; Internal fixation
分类号:
R683.41
文献标志码:
A
摘要:
目的探讨星型钢板小切口治疗肱骨大结节骨折的临床疗效。方法2010年5月~2012年12月我院采用星型钢板微创治疗17例肱骨大结节骨折，均为闭合性损伤且肱骨大结节骨折块均向上移位超过5 mm和(或)向后移位超过10 mm。臂丛神经阻滞麻醉（15例）或全麻（2例）下，取仰卧位，经肩部正中切口约3.5 cm，依次切开皮肤及各层组织，直至显露骨折块，撬拨复位，选用星型钢板固定撕脱的大结节骨块，若撕脱的骨块偏大加用1~2枚空心螺钉协助固定。术中被动活动肩关节，见骨折固定牢固，无松动。术后患肢悬吊胸前固定，术后1周开始被动进行肩关节的功能锻炼，2周拆线，3周后进行肩关节主动功能锻炼。结果17例均顺利完成手术，手术时间平均35 min（30~40 min），术中出血量平均42 ml（35~48 ml），住院时间平均7 d（6~9 d）。均无切口感染、骨不愈合、神经损伤、内固定松动等并发症。17例随访12～24个月，平均18个月，切口均一期愈合。17例术后4~6个月X线显示骨折愈合，均达到影响学解剖复位标准。末次随访肩关节Constant评分平均96.2分（94.5~97.8分）。结论星型钢板治疗单纯肱骨大结节骨折具有骨折不易移位，内固定牢靠，肩关节早期功能锻炼等优点，疗效满意。
Abstract:
ObjectiveTo observe clinical effects of application of small incision and star plate in the treatment of greater tuberosity fractures.MethodsA retrospective analysis of 17 cases of humeral greater tuberosity fracture treated by star plate fixation from May 2010 to December 2012 was carried out. All the fractures were caused by blunt trauma. The humeral greater tuberosity fracture fragments were displaced upwards over 5 mm and (or) backwards over 10 mm. Under brachial plexus anesthesia (15 patients) or general anesthesia (2 patients), the patients were operated in a supine position. Through a shoulder incision approximately 3.5 cm in length, layers of tissues were cut open until the exposure of the fracture blocks. After poking reduction, a star plate fixation of the greater tuberosity avulsion bone was employed. If the bone avulsion was relatively large, 1 or 2 cannulated screws were utilized for fixation assistance. During the surgery, the shoulder was passively mobilized to confirm the fixation without loosening. Postoperatively, the limb was suspension fixed before the chest. Passive functional exercise was given at 1 postoperative week. The stitches were removed 2 weeks after surgery. Active functional exercise of the shoulder was conducted 3 weeks after surgery. ResultsThe operation was accomplished in all the 17 cases. The mean operation time was 35 min (30-40 min), the mean intraoperative blood loss was 42 ml (35-48 ml), and the mean length of hospital stay was 7 d (6-9 d). No incisional infection, nonunion, nerve injury, or internal fixation loosening were detected. All the 17 patients were followed up for 12-24 months (mean, 18 months). All of the incisions got healing by first intention. The Xray showed that fractures healed 4-6 months after operation. According to the last followup date postoperative constant scores, an average of 96.2 points (94.5-97.8 points) was obtained.ConclusionUse of star plate for the treatment of simple humeral greater tuberoses fracture has advantages of seldom fracture displacement, internal rigid fixation, and early functional exercise of shoulder joint.

参考文献/References:

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更新日期/Last Update: 2014-12-20