劈裂型肱骨大结节骨折低切迹钢板固定与肩袖锚定

Low-profile plate and rotator cuff anchoring for split-type humeral greater tuberosity fractures

摘要:

［目的］ 探讨低切迹钢板固定联合缝线锚定肩袖治疗劈裂型肱骨大结节骨折的临床疗效。［方法］ 回顾性分析 2017 年 6 月—2019 年 6 月在本院行手术治疗的劈裂型肱骨大结节骨折 34 例患者的临床资料，对合并盂肱关节脱位的患者入院后即行手法复位，均采用经三角肌前中劈开入路低切迹钢板固定与缝线锚定肩袖。［结果］所有患者均顺利完成手术，手术时间平均 （86.56±10.37）min；术中出血量平均（72.44±12.42）ml。手术切口均 1 期愈合，无医源性神经、血管损伤等发生。所有患者均获随访（14.48±2.36）个月。VAS 评分随时间推移显著下降（P<0.05），而 Constant-Murley 评分显著增加（P<0.05）。所有患者均无肩峰下撞击、骨折延迟愈合或不愈合及内固定物松动断裂等不良影像表现。［结论］低切迹钢板联合锚定技术是治疗劈裂型肱骨大结节骨折的有效方法。

Abstract:

[Objective] To explore the clinical outcomes of low- profile plate fixation combined with rotator cuff anchoring for splittype humeral greater tuberosity fractures. [Methods] From June 2017 to June 2019, 34 patients underwent surgical treatment for split-type humeral greater tuberosity fractures in our hospital. The patients who had glenohumeral dislocation of joint were treated with manual reduc- tion immediately after admission, and all of them received open reduction and internal fixation with low-profile plate and suture anchoring of rotator cuff through anterior middle deltoid splitting approach. [Results] All patients had operation completed successfully, with an opera- tion time of (86.56±10.37) min, intraoperative blood loss of (72.44±12.42) ml, and primary incision healing, whereas without iatrogenic nerve and vascular injury. As time went during the follow-up lasted for (14.48±2.36) months, the VAS score significantly decreased (P＜ 0.05) , while Constant-Murley score significantly increased (P＜0.05) . No adverse imaging manifestations, such as subacromial impinge- ment, delayed fracture union, and loosening of the implant were noted in anyone of them. [Conclusion] This low-profile plate and rotator cuff anchoring are an effective treatment for split humeral greater tuberosity fractures.