摘要
目的评价采用肩峰前外侧入路治疗肱骨近端骨折的疗效和并发症。方法本组资料共有36例不稳定肱骨近端骨折患者采用肩峰前外侧入路行骨折切开复位锁定钢板固定。术后6周行腋神经临床和肌电图检查,如异常在术后3、6、12月时复查;功能评价为术后6月和12月时的Constant评分;其它指标包括影像学评价和相关并发症。结果 3例患者肌电图显示腋神经牵拉损伤但无临床表现;Constant评分在6月和12月时为(73.8±9.8)和(85.4±7.9),差异有统计学意义(P<0.01);5例骨折复位不良;1例1年后出现肱骨头坏死。结论采用肩峰前外侧入路锁定钢板固定治疗肱骨近端骨折能够取得满意疗效,术中注意腋神经保护可使其损伤风险最小化。
Objective To evaluate the clinical results and the complications of treatment Proximal Humerus Fractures through anterolateral acromial Approach. Methods Open reduction and locked plate osteosynthesis through anterolateral acromial Approach were implemented in 36 patients with unstable proximal humerus fracture. Clinical and Electrophysiological assessment of axillary nerve function were done at 6 weeks and at 3, 6, and 12 months postoperatively in those patients in whom an abnormality was detected postoperatively. Functional outcome was measured using normalized Constant scores at 6 and 12 months. Other meas- ures include radiological assessment and complications. Results Traction injury of the anterior part of the axillary nerve was electrically evident but not clinically apparent in 3 patients; The normalized Constant score were （73.8 ± 9. 8 ） at 6 months and（ 85.4 ± 7.9） at 1 year（ P 〈 0.01 ） ; Union was obtained in all patients. Malreductions were seen in 5 patients; one patient had radiologieal evidence of avaseular necrosis at 1-year follow-up. Conclusion Locked plating of proximal humerus fractures through anterolateral acromial approach provides satisfactory outcomes. Axillary nerve injury is the only limitation of the approach and can beminimized with careful identification and protection of the nerve throughout the procedure.
出处
《四川医学》
CAS
2014年第10期1301-1303,共3页
Sichuan Medical Journal
关键词
三角肌劈开
前外侧
肱骨近端骨折
微创
锁定钢板固定
deltoid splitting
anterolateral
proximal humerus fracture
minimally invasive surgery
Locking plate fixation
