Wolf T, Schauwecker F
Unfallchirurgie. 1987 Apr;13(2):106-9. doi: 10.1007/BF02585989.
In most cases isolated avulsions of the great tubercle can be treated conservatively. 31 Patients suffering from an isolated avulsion of the great tubercle had to go through an after-examination. 30 of these patients were fixed on the conservative method for three to four days mostly, usually with a Desault-dressing, and, subsequently, they had to undergo a functional after-treatment, even if the dislocation of the fragment was partly more than 1 cm. Only once, in the case of subacromial position of the fragment, an operative fixation was performed. On an average, an after-examination followed 1.8 years after the accident. Only eight patients complained about occasional trouble, five of whom, only, suffered from a slight reduction of mobility. It was remarkable that the occurring discomfort had nothing to do with the original degree of the dislocation of the fragment. In all, with the therapy performed as described above, a satisfying functional healing result was achieved. According to the present results, the operative fixation only has to be performed in the case of mechanical disability with a dislocation underneath the acromion.
在大多数情况下,大结节孤立性撕脱伤可采用保守治疗。31例患有大结节孤立性撕脱伤的患者必须接受复查。这些患者中的30例大多采用保守方法固定三到四天,通常采用德索(Desault)包扎法,随后,即使碎片移位部分超过1厘米,他们也必须接受功能康复治疗。仅在1例碎片位于肩峰下位置的情况下,进行了手术固定。平均而言,事故发生后1.8年进行复查。只有8例患者偶尔抱怨有问题,其中只有5例活动度略有下降。值得注意的是,出现的不适与碎片移位的原始程度无关。总之,采用上述治疗方法,取得了令人满意的功能愈合结果。根据目前的结果,仅在肩峰下有移位的机械性功能障碍的情况下才需要进行手术固定。