摘要
目的探讨应用肱骨近端髓内针治疗肱骨近端两部分外科颈骨折的疗效。方法回顾性分析22例应用锁定型肱骨近端髓内针治疗两部分外科颈新鲜骨折患者的临床资料,患者平均年龄57岁。最终随访时拍摄肩关节 x 线片以评价愈合情况,并应用可视模拟评分法(VAS)评分,美国肩肘外科医师评分(ASES),Constant-Murley 评分,UCLA 评分以及简易肩关节测验(SST)问卷评估。结果所有患者均获随访,平均随访时间为13个月,22例患者骨折均在术后8周内初步愈合。随访过程中未出现感染、肱骨头坏死以及任何与内固定物有关的并发症。术后患肢主动前屈上举平均为147.8°,主动体侧外旋平均为45.5°,主动内旋平均达T10水平。术后患者疼痛 VAS 评分平均为1.5。平均 ASES 评分为81.2,Constant-Murley 评分为85.4,UCLA 评分为29.9,SST 评分为9.5。18例患者的肩关节功能评估为优或良,4例患者肩关节功能评估为差。结论闭合复位、锁定型肱骨近端髓内针固定术是治疗肱骨近端两部分外科颈骨折的一种有效的手术方式。
Objectives To investigate the results of two-part surgical neck fractures of proximal humerus treated with locking intramedullary nail for proximal humerus, and to discuss the indication, surgical technique and the effectiveness. Methods The data of the 22 patients with two-part surgical neck fractures fixed with proximal humeral nail was retrospectively reviewed. The mean age was 57 years. X-ray film and visual analogue scale （ VAS）, American shoulder and elbow surgeon （ASES） score, ConstantMurley score, University of California, Los Angeles （UCLA） scoring system and simple shoulder test （SST） questionnaire were used to evaluate the patients＇ shoulder function recovery at final follow-up. Result All the patients were followed up with an average time of 13 months. All fractures united within 8 weeks postoperatively. No infection, avascular necrosis or complications which concerning with hardware was found during follow-up. The average active forward flexion was 147. 8°, the average external rotation was 45.5° and the average internal rotation was TIO. The mean VAS score was 1.5. The mean ASES score, ConstantMurley score, UCLA score and SST score were 81.2, 85.4, 29.9 and 9. 5 respectively. Eighteen patients were rated as ＂excellent＂ or ＂good＂, while 4 others were rated ＂poor＂. All patients were satisfied with their results. Conclusion With good indication control, meticulous intraoperative management and strict postoperative rehabilitation, close reduction and internal fixation with proximal humeral nail can be an effective method for the treatment of two-part surgical neck fracture.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2007年第20期1385-1388,共4页
Chinese Journal of Surgery
关键词
肩骨折
骨折固定术
髓内
肱骨近端髓内针
Shoulder fractures
Fracture fixation, intramedullary
Proximal humerus nail
