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采用微创经三角肌入路治疗肱骨近端骨折的短期临床疗效

Short-term Clinical Outcome of Proximal Humeral Fracture Fixation Using Minimally Invasive Trans-Deltoid Approach.

作者信息

Abouelela Amr, Mubark Islam, Nagi Ahmed, Genena Ahmed

机构信息

University Hospital Derby and Burton, UK.

University Hospital Derby and Burton, UK.

出版信息

Ortop Traumatol Rehabil. 2020 Aug 31;22(4):221-226. doi: 10.5604/01.3001.0014.3458.

Abstract

BACKGROUND

This study examined the clinical outcomes of fixation of displaced fractures of the proximal humerus using a trans-deltoid approach.

MATERIAL AND METHODS

Twenty patients (13 male and 7 female) were treated with this technique, with a mean age of the patients of 38.85 years (range, 19 to 64 years). All patients were followed up for at least twelve months and were evaluated according to the Constant shoulder score.

RESULTS

The mean Constant Shoulder score was 87.45, ranging from 63 to 100. Ten patients (50%) had excellent results, four patients (20%) had good results, three patients (15%) had satisfactory results, and three had adequate results (15%). There was a statistically significant difference between the type of the fracture and the final score (p=0.013), where 3-part fractures with impaction (11-B1), either valgus or varus impaction, showed higher scores than those without impaction. Four patients presented with post-operative complications varying from superficial infection to radial nerve palsy.

CONCLUSIONS

  1. The trans-deltoid approach was a safe and reliable alternative to the delta-pectoral approach for the treatment of displaced proximal humerus fractures. 2. The impacted (11-B1) fracture type was a signifi-cant contributing factor in terms of good functional outcomes.
摘要

背景

本研究探讨采用经三角肌入路治疗肱骨近端移位骨折的临床疗效。

材料与方法

20例患者(男13例,女7例)接受了该技术治疗,患者平均年龄38.85岁(范围19至64岁)。所有患者均随访至少12个月,并根据Constant肩关节评分进行评估。

结果

Constant肩关节平均评分为87.45分,范围为63至100分。10例患者(50%)结果为优,4例患者(20%)结果为良,3例患者(15%)结果为满意,3例患者(15%)结果为尚可。骨折类型与最终评分之间存在统计学显著差异(p = 0.013),其中伴有嵌插的三部分骨折(11 - B1型),无论是外翻嵌插还是内翻嵌插,评分均高于无嵌插者。4例患者出现术后并发症,从浅表感染到桡神经麻痹不等。

结论

  1. 经三角肌入路是治疗肱骨近端移位骨折的一种安全可靠的替代三角肌胸大肌入路的方法。2. 嵌插型(11 - B1型)骨折类型是功能良好预后的一个重要影响因素。

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