单纯性肱骨大结节骨折治疗进展

Progress of treatment on isolated fractures of the greater tuberosity of the proximal humerus

肱骨大结节是肩关节肱骨近端的重要结构,是肩袖的附着点,为肩关节的运动提供杠杆支点,对肩关节的外展和外旋有重要作用。肱骨大结节骨折可致肩关节疼痛、不稳、外展外旋活动受限,严重者可对患者的日常生活和心理带来较大影响。以往临床上对单纯性肱骨大结节骨折的认识及重视程度不够,多采用保守治疗。近年来随着肱骨近端生物力学研究的深入和材料科学的发展,肱骨大结节骨折的诊治得到了较大的进展,多数学者认为无移位或轻度移位(<5mm)的骨折可采取保守治疗,对明显移位(>5 mm)的骨折建议手术治疗。本文对肱骨大结节骨折治疗研究进行综述,总结出肱骨大结节骨折的分型、骨折治疗方式及其优缺点,以期为临床医生诊治肱骨大结节骨折提供参考。

As greater tuberosity of the proximal humerus supplies attachment point to rotator cuff,it plays a very important role in the abduction and extorsion of shoulder joint.Patients with isolated fractures of the greater tuberosity of the proximal humerus were often treated nonoperatively in the past,however,it led to complications of pain,stiffness,and loss of shoulder function.According to the literature research,we found that most scholars believed that patients with nondisplaced or slightly displaced fractures(<5 mm)could be treated nonoperatively and patients with moderately or major displaced fractures(>5 mm)should be operated.This article is a review of isolated fractures of the greater tuberosity of the proximal humerus mainly on damage mechanisms,fracture types and ways of operation.It aims to summarize the relevant concepts and clinical applications on isolated fractures of the greater tuberosity and to provide a reference for its treatment.