George Michael S
KSF Orthopaedic Center, Houston, TX 77090, USA.
J Am Acad Orthop Surg. 2007 Oct;15(10):607-13. doi: 10.5435/00124635-200710000-00005.
Isolated fractures of the greater tuberosity of the humerus can occur in anterior shoulder dislocations or as the result of an impaction injury against the acromion or superior glenoid. Greater tuberosity fractures may be associated with partial-thickness rotator cuff tears and labral tears, which may be the cause of persistent pain after fracture healing. Nondisplaced and minimally displaced fractures are typically treated successfully nonsurgically. Surgical fixation is recommended for fractures with >5 mm of displacement in the general population or >3 mm of displacement in active patients involved in frequent overhead activity. Open surgical repair is performed with suture or screw fixation. Recently, arthroscopic techniques have produced promising results. Careful follow-up and supervised rehabilitation optimize results after both nonsurgical and surgical treatment.
肱骨大结节孤立性骨折可发生于肩关节前脱位时,或因肩部撞击肩峰或肩胛盂上缘所致。大结节骨折可能合并部分厚度的肩袖撕裂和盂唇撕裂,这可能是骨折愈合后持续疼痛的原因。无移位和轻微移位的骨折通常非手术治疗即可成功。一般人群中移位>5 mm或频繁进行过头活动的活跃患者中移位>3 mm的骨折建议手术固定。开放手术修复采用缝线或螺钉固定。近年来,关节镜技术取得了令人鼓舞的成果。无论是非手术还是手术治疗后,仔细的随访和有监督的康复训练都能优化治疗效果。