肩关节脱位合并肱骨颈骨折的治疗

Treatment of dislocation of shoulder associated with fracture of humeral neck

目的探讨肩关节脱位合并肱骨颈骨折的治疗方法及疗效。方法从1995年1月至2002年12月对19例肩关节脱位合并肱骨颈骨折患者,行整复、外固定(或尺骨鹰嘴牵引)13例;切开复位内固定6例。结果整复、外固定(或尺骨鹰嘴牵引)13例随访结果,肩关节疗效满意;切开复位内固定6例,5例随访结果肩关节疗效欠佳。结论肩关节脱位合并肱骨颈骨折的治疗,大部分非手术治疗效果满意;手术治疗应重视肩袖损伤和肱骨头坏死的问题。

Objective To investigate the therapeutic method and efficacy of dislocation of shoulder associated with fracture of humeral neck.Methods From Jenuary 1955 to Desember 2002,19 cases with disdocation of shoulder associated with fracture of humeral neck were analyzed restrospectively.The closed reduction and external fixation(or skeletal traction through olecranon of ulna)were in 13 cases.Open reduction and internd fixation 6 cases.Results With follow up of 13 cases;the efficacy of shoulder was satisfactory in using closed reduction and external fixation.Among 6 cases with open reduction and internal fixation,the efficacy of shoulder were not so good in 5 cases.Conclusion The efficacy of majority non operative treatment is satisfactory in the treatment of dislocation of shoulder associated with fracture of humeral neck.Operative treatment should be pay attention to the ploblem of the rotator cuff injury and necrosis of humeral head.