[1]高益斌,童松林.肱骨大结节骨折内固定术后并发症发生的原因及对策[J].中医正骨,2021,33(04):75-77.
　GAO Yibin,TONG Songlin.Postoperative complications of internal fixation surgery for treatment of humeral greater tuberosity fractures:cause analysis and coping strategies[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(04):75-77.
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肱骨大结节骨折内固定术后并发症发生的原因及对策()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年04期
页码:
75-77
栏目:
诊治失误案例分析
出版日期:
2021-04-20

文章信息/Info

Title:
Postoperative complications of internal fixation surgery for treatment of humeral greater tuberosity fractures:cause analysis and coping strategies
作者:
高益斌; 童松林
(慈溪市人民医院,浙江 慈溪 315300)
Author(s):
GAO Yibin; TONG Songlin
关键词:
肩骨折;  肱骨骨折;  骨折固定术; 内;  手术后并发症
摘要:
目的:探讨肱骨大结节骨折内固定术后并发症发生的原因及对策。方法:对2010年6月至2020年6月治疗的35例内固定术后出现并发症的肱骨大结节骨折患者的病例资料进行回顾性分析。男19例,女16例; 年龄34～67岁,中位数51岁。初次内固定方式为肱骨近端解剖锁定钢板内固定13例、空心螺钉内固定9例、锚钉内固定10例、张力带联合锚钉内固定3例。初次内固定术后并发内固定失效21例、肩峰撞击征7例、肩袖再撕裂4例、腋神经损伤3例。骨折延迟愈合15例、不愈合2例。根据初次手术的内固定方式及并发症情况,进行支具外固定、拆除原内固定物、重新内固定、修复肩袖组织等处理,肱骨头缺损区均植骨。观察骨折愈合及肩关节功能恢复情况。结果:本组35例患者,并发症处理采用支具外固定6例、二次手术29例; 均获随访,随访时间6～23个月,中位数11个月。骨折延迟愈合或不愈合的17例患者,骨折均愈合,愈合时间6～14周,中位数8周。支具去除或二次手术后6个月,采用美国肩肘外科(American shoulder and elbow surgeons,ASES)评分评价肩关节功能,本组患者肩关节ASES评分(80.9±5.7)分。结论:对于肱骨大结节骨折,内固定术后发生并发症主要有忽视对肩关节周围组织损伤的评估和修复及内固定方式不当两大原因。术前对损伤进行全面、准确的评估,手术选择合适的内固定方式,重视对肩关节周围组织的修复,有利于减少术后并发症的发生。对于已发生术后并发症的肱骨大结节患者,根据初次手术的内固定方式及并发症情况,选择合适的处理方式,可促进骨折愈合和肩关节功能恢复。

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备注/Memo

备注/Memo:
基金项目:浙江省医药卫生科技计划项目(2017KY143)
更新日期/Last Update: 1900-01-01