改良肩关节前外侧入路手术治疗肱骨近端骨折临床疗效分析

Clinical Analysis of Surgical Treatment of Proximal Humerus Fracture with Modified Anterolateral Approach of Shoulder Joint

目的分析改良肩关节前外侧入路手术治疗肱骨近端骨折的临床疗效。方法该文方便选取的31例肱骨近端骨折均为该院2016年1月—2017年12月所收治,全部患者均给予改良肩关节前外侧入路手术治疗,观察分析临床疗效。结果对患者进行为期1~12个月的随访发现,全部31例患者均实现骨性愈合。并没有发生肱骨头坏死、内置物失效、腋神经损伤等并发症。临床治疗优良率为93.55%(29/31)。患者术后3个月的VAS评分显著低于术前,Constant-Murley肩关节功能评分显著高于术前,比较差异有统计学意义(t=37.069 7,10.769 3;P<0.05)。结论在对肱骨近端骨折患者进行治疗时,选择改良肩关节前外侧入路手术治疗能取得比较理想的效果,值得临床推广。

Objective To analyze the clinical effect of an improved anterolateral approach of the shoulder joint for the treatment of proximal humerus fractures. Methods 31 cases of proximal humerus fractures were convenient selection and treated in the hospital from January 2016 to December 2017. All patients were treated with an improved anterolateral approach to the shoulder joint. Clinical efficacy was observed and analyzed. Results A follow-up period of 1-12 months was found in the patients and all 31 patients achieved bony union. There were no complications such as humeral head necrosis, built-in failure, and radial nerve injury. The clinical treatment rate was 93.55%（29/31）. The VAS score at 3 months after surgery was significantly lower than before surgery, and the Constant-Murley shoulder function score was significantly higher than before surgery. The difference was statistically significant（t=37.069 7,10.769 3; P〈0.05）. Conclusion In the treatment of patients with proximal humeral fractures, the choice of improved surgical treatment of the anterolateral approach of the shoulder can achieve satisfactory results and is worthy of clinical promotion.