手法复位外展牵引治疗肱骨外科颈骨折合并肩关节前脱位21例

目的观察手法复位、小夹板外固定,配合外展牵引治疗肱骨外科颈骨折合并肩关节前脱位的疗效。方法手法复位并整复肱骨外科颈骨折,然后按骨折移位方面放置好压垫,上臂略超肩关节夹板外固定,常规消毒,局麻下行尺骨鹰嘴骨牵引、前臂皮肤牵引。早期进行握拳和肘腕关节主动屈伸运动等功能锻炼。结果21例肱骨外科颈骨折合并肩关节前脱位均获满意复位,骨折全部治愈,功能恢复快。结论手法复位、小夹板外固定,配合外展牵引的方法治疗肱骨外科颈骨折合并肩关节前脱位简便、安全,复位成功率高,创伤小,既能避免肱骨头发生滑脱及骨折再度移位,达到有效的固定,又能进行早期功能锻炼,预防关节粘连、肌肉萎缩、骨质疏松,有利于促进骨折的愈合,达到了“动静结合”的治疗目的。

Manipulative reduction with external traction on surgical neck of humerus fracture with shoulder dislocation

Objective To observe the manipulative reduction external traction on fracture of surgical neck of humerus with shoulder dislocation.Methods 21 patients with humerus surgical neck fracture with shoulder ventro-dislocation were treated with manipulative reduction,the surgical neck fracture restitution,and then laid up the pressure pad along the displacement fracture direction.Under routine sterilization,anconeal process of ulna skeletal traction was performed with local anesthesia and upper arm skin traction was done.Function exercise such as clenching fist,initiative flexion and extend elbow darpal articulations were conducted in the ealy stage.All the patients were administered Chinese herbal medicine.Result All the patients with humerus surgical neck fracture and shoulder dislocation were replaced satisfactorilly.Conclusions Method of manipulative reuction,splintlet external fixation with abduction traction is simple,safe and have high reposition rate to treat humerus surgical neck fracture with shoulder ventro-dislocation.This method can both effectively avoid caput humeri slippage,fracture displace at second time,and combination with early functional exercise,thus prevent synarthrophysis,amyotrophy and osteoprosis,helping to promote fracture healing.