Imhoff M, Sadr I, Lehner J H, Hasse F M, Gahr R H
Chirurgische Klinik, Städtischen Kliniken Dortmund.
Aktuelle Traumatol. 1992 Apr;22(2):65-71.
Between 1978 and mid-1990, 135 patients suffering from dislocated, non-luxated fracture of the humerus at the anatomical neck (fractura colli anatomici) were treated by means of open or closed percutaneous drill wire osteosynthesis. Follow-up examination after an average of 9 months did not show any significant differences between the two surgical approaches in 117 patients, independent of the shape of the fracture. However, in about 30% of the cases it was impossible to employ the percutaneous approach due to the presence of an obstacle to reduction, so that open reduction and fixation was the only choice. A great majority of the functional results must be considered as good, fractures of the tubercles having the most unfavourable prognosis independent of the surgical technique. It is, therefore, recommended to first try closed reduction with percutaneous drill wire osteosynthesis. If there are any obstacles to reduction, open reduction should be restored to during the surgery session.
1978年至1990年年中，135例肱骨解剖颈脱位、非脱位骨折（解剖颈骨折）患者接受了开放或闭合经皮穿针钢丝内固定治疗。平均9个月后的随访检查显示，117例患者的两种手术方法之间没有任何显著差异，与骨折形状无关。然而，在大约30%的病例中，由于存在复位障碍，无法采用经皮手术方法，因此切开复位内固定是唯一的选择。大多数功能结果被认为是良好的，无论手术技术如何，结节骨折的预后最不理想。因此，建议首先尝试闭合复位经皮穿针钢丝内固定。如果存在任何复位障碍，应在手术过程中改为切开复位。
