双排锚钉缝线桥技术治疗老年肱骨大结节骨折

目的 探究双排锚钉缝线桥技术在治疗老年肱骨大结节骨折中的临床疗效。方法 回顾性分析2017年1月至2018年12月收治的17例60岁及以上老年肱骨大结节骨折临床资料,均采用肩关节外侧入路直视下复位大结节,双排锚钉缝线桥技术固定。术后2周内吊带制动下行肩关节钟摆样活动,2周后去除外固定开始早期功能锻炼。结果 17例患者术后随访9~24个月,平均(14.0±5.4)个月。无伤口感染、骨折再移位、肩关节僵硬等并发症。末次随访肩关节Constant-Murley评分平均(88.6±12.5)分(80~95分),其中优12例,良5例,优良率100%。VAS疼痛视觉模拟评分平均(0.8±0.6)分(0~2分)。结论 双排锚钉缝线桥技术治疗老年肱骨大结节骨折,手术创伤小,避免二次损伤大结节骨块,固定充分且牢靠,可满足早期功能锻炼,取得满意的疗效。

Double-row suture anchor bridge fixation in the treatment of greater turberosity fracture in elderly patients

Objective To investigate the clinical outcome of double-row suture anchor bridge fixation in the treatment of humeral greater tuberosity fracture in elderly patients. Methods Clinical data of 17 cases of greater tuberosity fracture in elderly patients over 60 years old who were treated from January 2017 to December 2018 were analyzed retrospectively. All cases were treated by lateral approach, open reduction and fixation by double-row suture anchor bridge technique. The shoulder were supported by suspension sling and taken pendulum exercise in 2 weeks after operation. After 2 weeks, the external fixation was removed and early functional exercise should be taken. Results All the 17 patients were followed up for 9 to 24 months with an average of 14.0±5.4 months. There were no complications such as incision infection, fracture redisplacement and joint stiffness. The average Constant-Murley score of shoulder was 88.6±12.5(80-95), 12 cases were excellent, 5 cases were good, and the excellent and good rate was 100%. VAS(visual analogue pain score)was used to assess pain situation. The mean VAS score was 0.8±0.6(0-2). Conclusion This study demonstrates that double-row suture anchor bridge fixation is a reliable option in the treatment of greater tuberosity fracture in elderly patients, which has the advantages of minimal surgical incision, preventing secondary injury to greater tubercle fragment, and allowing early active shoulder rehabilitation.