摘要
目的评价肩关常镜辅助经皮空心钉或缝合锚固定治疗肱骨大结节骨折的临床疗效。方法回顾性研究2005年1月至2008年2月收治并获得随访的21例单纯撕脱型二部分肱骨大结节骨折患者资料，男7例，女14例；平均年龄（50．5±9．5）岁（34～68岁）；左侧11例，右侧10例。受伤至手术时间平均为（9．6±4．4）d。21例患者均使用肩关节镜辅助经皮空心钉或缝合锚钉固定治疗。术后3周、6周、12周、6个月、12个月以及末次随访时摄手外旋中立位肩关节正位、侧位和腋位x线片，以判断骨折愈合情况。末次随访时采用视觉模拟评分法（VAS）疼痛评分、美国肩肘外科医师（ASES）评分、Constant．Murley评分及加州大学洛杉矶分校（UCLA）评分评价肩关节功能恢复情况。结果21例患者术后获平均38．1个月（23～60个月）随访。末次随访时患者肩关节活动度：前屈上举平均为160．5°±6．7°，外旋平均为65．7°±6．0°．内旋达T9±3水平，VAS疼痛评分平均为（0．5±1．1）分，ASES评分平均为（95．8±6．6）分，Constant—Murley评分平均为（97．2±3．0）分，UCLA评分平均为（34．6±0．7）分。术后手外旋肩关节正位、侧位和腋位x线片复查，所有患者骨折均获愈合，平均愈合时间为（7．2±2．0）周（6～12周）。本组无一例出现内固定失效、骨折移位、神经血管损伤等并发症。结论肩关节镜辅助经皮空心钉或缝合锚固定治疗肱骨大结节骨折临床疗效好，是一种安全有效的治疗方法。
Objective To evaluate the resuhs of arthroscupic reduction and fixation with percutaneous cannulated screws or double-row suture anchor for treatment of 2-part fractures of the greater tuberosity. Methods A retrospective study was done to analyze 21 patients with a displaced fracture of the greater tuberosity who had undergone arthroscopic treatment frnm January 2005 to February. 2008 and been available for the entire follow-ups. They were all treated with arthroseopic reduction and fixation with percutaneous cannulated screws or double-row suture anchor. They were 7 men and 14 women with an average age of 50.5 ±9.5 years （range, 34 to 68 years） . Eleven left shoulders and 10 right shoulders were involved. The mean time from injury to surgery was 9.6 ± 4.4 days. Results The patients were followed up for an average of 38. 1 months （range, 23 to 60 months）. The average ranges of motion of the patients were 160.5° ± 6.7°/65.7° ± 6.0°/T9± 3. The average visual analogue scale （VAS）, American Shoulder and Elbow Surgeons （ASES）, Constant-Murley, and University of California Los Angeles （UCLA） scores were 0. 5 ± 1. 1 （0 to 4）, 95.8 ± 6.6 （75 to 100）, 97. 2±3.0, and 34. 6±0. 7 respectively. There was no hardware ：failure or re-displacement of the fracture. All patients healed without any major complications related to the surgery. Conclusion Arthro- seopic reduction and fixation with percutaneous cannulated screws or double-row suture anchor is a safe and effective method to treat displaced fractures of the greater tuberosity.
出处
《中华创伤骨科杂志》
CAS
CSCD
2010年第4期303-307,共5页
Chinese Journal of Orthopaedic Trauma
关键词
关节镜检查
肩骨折
骨钉
缝合锚
Arthroscopy
Shoulder fracture
Bone nails
Suture anchor
