经三角肌入路锁定钢板内固定治疗肱骨外科颈骨折

目的探讨经三角肌入路锁定钢板内固定治疗肱骨外科颈骨折的安全性及疗效。方法自2010-08—2013-01采用经三角肌入路治疗肱骨外科颈骨折32例,术中显露保护腋神经后复位骨折并用锁定钢板固定。观察手术情况、术后骨折复位和肩关节功能恢复情况。结果所有患者术后获得至少12个月,平均15个月的随访,所有骨折均获得愈合,未发生腋神经损伤,肩关节功能采用Neer评分系统评估,优良率90.6%。结论肩前外侧入路利用三角肌前中亚部肌间隙,能够显露和保护腋神经,直视下复位骨折钢板内固定,具有固定牢靠、创伤小、安全等特点。

Application of locking plate through deltoid-splitting approach for treatment of fracture of surgical neck of humerus

Objective To investigate the safety and efficacy of treating fracture of surgical neck of humerus with locking plate through deltoid-splitting approach. Methods From August 2010 to January 2013,32 patients with surgical neck of humerus fractures were treated with locking plates through deltoid-splitting approach. The axillary nerve was revealed and protected before fracture reduction and fixation. The postoperative fractures reduction and shoulder joint function were evaluated after surgery. Results All the patients were followed for at least 12 months with a mean period of 15 months. All fractures healed up. Axillary nerve injury was not found. According to Neer criteria for shoulder joint function, the excellent and good rate was 90.6%. Conclusion The deltoid-splitting approach using the front and middle deltoid muscle gap, can reveal and protect the axillary nerve. Open reduction and fixation under direct vision has following advantages： minor injuries, stable fixation and safety, which is an ideal method to treat fracture of surgical neck of humerus.