肩前外侧经三角肌入路内固定在肩关节脱位合并肱骨大结节骨折中应用.docVIP

肩前外侧经三角肌入路内固定在肩关节脱位合并肱骨大结节骨折中应用 　　[摘 要] 目的：?^察肩前外侧经三角肌入路内固定在肩关节脱位合并肱骨大结节骨折中的效果，总结临床应用体会。方法：回顾85例肩关节脱位合并肱骨大结节骨折患者临床资料。接受肩前外侧经三角肌入路微型钢板螺钉内固定者为观察组（n=39），接受传统肩前三角肌、胸大肌入路肱骨近端解剖钢板螺钉内固定者为对照组（n=46），比较两组手术情况、恢复情况及并发症发生情况，并评价其术后9个月肩关节功能优良率。结果：观察组切口长度、手术时间、术中出血量均低于对照组，差异有统计学意义（P0.05）。观察组术后肩峰下撞击综合征发生率为5.13%（2/39），低于对照组的10.87%（5/46）；观察组术后9个月肩关节功能优良率为87.18%，高于对照组的56.52%，差异均有统计学意义（P0.05）。结论：与传统入路相比，肩前外侧经三角肌入路能够进一步降低手术创伤、缩短手术时间、降低术后肩峰下撞击综合征发生率、促进早期恢复，是一种安全、可靠的新型入路方案。 　　[关键词] 肩前外侧；三角肌入路；内固定；肩关节脱位；肱骨大结节骨折 　　中图分类号：R684.7 文献标识码：A 文章编号：2095-5200（2017）05-106-03 　　DOI：10.11876/mimt201705044 　　The use of internal fixation of shoulder anterolateral by the deltoid approach in the shoulder joint dislocation combined with the greater tuberosity of humerus LI Renjie. （Department of Orthopedic Surgery，Meishan Second People’s Hospital， Meishan 620500， china） 　　[Abstract] Objective： The objective of this study was to observe the effect of internal fixation of shoulder anterolateral by the deltoid approach in the shoulder joint dislocation combined with the greater tuberosity of humerus. Methods： A total of 85 cases of shoulder joint dislocation combined with the large tuberosity of the humerus were collected. The patients who received the internal fixation of shoulder anterolateral by the deltoid approach in the shoulder joint dislocation combined with the greater tuberosity of humerus were divided into observation group （n=39） ， while the patients who were treated with traditional fixation of deltoid and pectoralis major muscle by proximal plate screw were considered as control group （n=46）. The operation， recovery and complication condition of two groups were compared and their shoulder joint function 9 months after operation were evaluated. Results： The length of incision， the length of operation and the volume of blood loss during the operation of observation group were lower than that of control group， and the difference was statistically significant （ P0.05）. The occurrence rate of su