经三角肌锁定钢板微创治疗肱骨近端骨折

摘要

目的：探讨肩部前外侧经三角肌分离入路应用锁定钢板微创固定治疗肱骨近端骨折的临床效果。方法：对2006年7月至2009年7月采用经肩部前外侧小切口入路锁定钢板微创固定治疗30例肱骨近端粉碎性骨折进行回顾分析，按neer分型二部分骨折5例，三部分骨折17例，四部分骨折8例，其中四例骨折线累计肱骨上、中段。手术遵循MIPPO技术，采用肩峰下前外侧经三角肌入路经皮钢板固定，避免传统手术广泛暴露造成肱骨头血运破坏。结果：本组手术时间60~130min，平均80min,术中出血50~300ml，未输血。切口全部一期愈合，30例均获随访，随访时间2~24个月，平均12个月，骨折均连接平均愈合时间10.6周，肩肘关节功能基本正常。结论：经肩部外侧经三角肌分离入路锁定钢板微创固定治疗肱骨近端骨折手术简单、安全、损伤小、术中出血少、愈合时间短、功能恢复好，值得推广。%Purpose Explore the the clinical effect of locking plate minimal y invasive fixation for the treatment of proximal humeral fractures by shoulder lateral deltoid muscle separation approach.Method The shoulder anterolateral smal incision minimal y invasive fixation for the treatment of 30 cases of locking plate of proximal humerus comminuted fracture were retrospectively analyzed. ResultThe operation time of 60~130min, the mean 80min, intraoperative bleeding is 50~300ml, without blood transfusion. Incision of al healed, 30 cases were fol owed up for 2 to 24 months fol ow-up period, mean 12 months, fractures are connected with an average healing time of 10.6 weeks, shoulder and elbow joint function of normal.ConclusionsThe shoulder from the outside by the deltoid on locking plate fixation of proximal humeral fracture with minimal y invasive operation is simple, safe, less injury, less bleeding, shorter healing time, bet er recovery of function, is worth popularizing.