微侵袭手术治疗肱骨近端骨折

Minimal invasive surgery in proximal humeral fractures

目的 探讨微侵袭手术治疗肱骨近端骨折的临床价值。方法 采用经肱骨鹰嘴窝上小切口多根针髓腔内固定治疗肱骨近端骨折 31例。结果 31例均获随访 ,随访时间 6～ 13个月 ,平均 8 4个月。骨折均临床愈合 ,愈合时间 6～ 11周 ,平均 6 8周 ,随访期间无肱骨头缺血坏死征象。ConstantScoringSystem综合评分 70～ 98分 ,平均 86 4分。临床疗效评估 :12例优 ,16例良 ,3例一般。 结论 采用经肱骨鹰嘴窝上小切口多根针髓腔内固定治疗肱骨近端骨折 ,手术创伤小 ,固定牢靠 ,肩关节可获得早期功能锻炼 ,可减少并发症 。

Objective To investigate the clinical value of the treatment of proximal humeral fractures with minimally invasive surgery. Methods 31 cases of proximal humeral fractures were treated with intramedullary multi pin fixation through minimal incision above the olecranon fossa. Results 31 cases were followed up for an average of 8 4 months (6 to 13 months). All cases acquired union of fracture within 6 to 11 weeks after operation, 6 8 weeks on the average. No sign of necrosis was found in humeral heads in the follow up. The average score was 86 4 (from 70 to 98) according to Constant Scoring System. Clinical evaluation was excellent in 12 cases, good in 16 cases and fair in 3 cases. Conclusion It is a good method to treat the proximal humeral fractures with intramedullary multi pin fixation through minimal incision, which has the advantages of less trauma on soft tissue, rigider fixation, earlier rehabilitation, and fewer complications.