Wei Changbao, Rui Yongjun, Wu Yongwei, Ma Yunhong, Zhou Ming, Kang Yongqiang, Wang Yapeng, Liu Jun
Department of Orthopedics, Wuxi Ninth People's Hospital, Suzhou University, Wuxi Jiangsu, 214062, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Sep 15;34(9):1120-1124. doi: 10.7507/1002-1892.202002104.
To observe effectivness and safeness of self-made dentation hook plate associated with hot-air balloon technique in treating Mutch Ⅰ or Ⅱ type isolated greater tuberosity fractures of humerus.
Between January 2016 and December 2018, 15 patients with Mutch Ⅰ or Ⅱ type greater tuberosity fractures were treated with self-made dentation hook plate associated with hot-air balloon technique. There were 9 males and 6 females with an average age of 45.1 years (range, 29-62 years). The injury causes included falling injury in 9 patients and traffic accident injury in 6 patients. According to Mutch classification, 4 cases were MutchⅠ type and 11 cases were Mutch Ⅱ type. There were 7 cases with anterior dislocation of shoulder. The time from injury to operation was 2-10 days (mean, 4.5 days).
All 15 patients were followed up 8-16 months, with an average of 13.5 months. There was no infection of incision, loss of reduction of fracture block, delayed union or nonunion. The average time of fracture union was 6.5 months (range, 4-8 months). One patient had axillary paralysis at 1 day after operation, and was treated with nutritional nerve therapy, the symptoms disappeared after 2.5 months. Three patients had slight subacromial impingement. After fracture healing, the hook plate was taken out in advance, and the pain and abnormal noise disappeared during shoulder abduction. At last follow-up, Costant-Murley score used to evaluate shoulder joint function was 88-100, with an average of 96.8; 8 cases were excellent, 7 cases were good, and the excellent and good rate was 100%. The internal fixator was removed after 8-16 months after the secondary operation with no re-fracture occurred.
The self-made dentation hook plate associated with hot-air balloon technique is a safe and reliable method for the treatment of Mutch Ⅰ or Ⅱ type isolated greater tuberosity fracture of humerus.
观察自制齿状钩钢板联合热气球技术治疗MutchⅠ或Ⅱ型孤立性肱骨大结节骨折的有效性和安全性。
2016年1月至2018年12月,采用自制齿状钩钢板联合热气球技术治疗15例MutchⅠ或Ⅱ型大结节骨折患者。其中男性9例,女性6例,平均年龄45.1岁(范围29 - 62岁)。受伤原因包括9例坠落伤和6例交通事故伤。根据Mutch分类,MutchⅠ型4例,MutchⅡ型11例。7例合并肩关节前脱位。受伤至手术时间为2 - 10天(平均4.5天)。
15例患者均获随访8 - 16个月,平均13.5个月。切口无感染,骨折块无复位丢失,无延迟愈合或不愈合。骨折平均愈合时间为6.5个月(范围4 - 8个月)。1例患者术后1天出现腋神经麻痹,经营养神经治疗,2.5个月后症状消失。3例患者有轻微肩峰下撞击。骨折愈合后提前取出钩钢板,肩关节外展时疼痛及异常响声消失。末次随访时,采用Constant - Murley评分评估肩关节功能,评分88 - 100分,平均96.8分;优8例,良7例,优良率为100%。二次手术后8 - 16个月取出内固定器,未发生再骨折。
自制齿状钩钢板联合热气球技术是治疗MutchⅠ或Ⅱ型孤立性肱骨大结节骨折的一种安全可靠的方法。