肩关节镜治疗16例肱骨大结节骨折及其相关合并损伤临床观察

Arthroscopic treatment of 16 cases of humerus greater tuberosity fractures and its related combined injury

[背景]探讨肩关节镜下经皮空心钉固定治疗肱骨大结节骨折的临床疗效.[病例报告]回顾性分析2009年10月～2011年10月间应用肩关节镜经皮空心钉固定治疗的16例肱骨大结节骨折的患者资料.随访术后并发症,定期复查X线片,评估骨折愈合情况,并根据Constant肩关节功能评分系统对术后肩关节功能进行评分.16例患者全部获得随访,随访时间为5～16个月,平均为9个月.术后无一例出现感染、神经损伤、内固定失效、骨折再移位等并发症,所有患者骨折均愈合良好.术后终末随访Constant肩关节功能评分为88～100分,平均为93.75分.[讨论]应用肩关节镜技术经皮空心钉固定治疗肱骨大结节骨折创伤小,诊断和治疗更加全面、准确,操作安全可靠,恢复快,术后并发症少,疗效满意,是有效的治疗方法.

BACKGROUND To discuss the clinical efficacy of arthroscopic fixation for the treatment of humerus greater tuberosity fractures with percutaneous cannulated screws. CASE REPORTS The data for 16 cases of humerus greater tuberosity fracture treated by the arthroscopic surgery from October 2009 to October 2011 were retrospectively analyzed, and it was followed up that the postoperative complications, review of X-ray slice at fixed period and evaluation of the status of fracture healing, and the postoperative shoulder joint function was assessed according to the Constant shoulder score. The follow-up time was from 5 m to 16 m （mean of 9 m）, and its results showed that there were no complications of infection, nerve injuries, internal fixation failure and fracture re-displacement after operation, and the fracture healing was well in all patients. The Constant shoulder score at the postoperation terminal follow-up was from 88 to 100 （mean of 93.75）. DISCUSSION Arthroscopic assisted percutaneous cannulated screws fixation of humerus greater tuberosity fracture is an effective treatment method smaller trauma, more comprehensive and accurate diagnosis and treatment, safe and reliable, faster recovery and fewer complications.