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[1]高益斌,童松林.肱骨大結(jié)節(jié)骨折內(nèi)固定術(shù)后并發(fā)癥發(fā)生的原因及對策[J].中醫(yī)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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肱骨大結(jié)節(jié)骨折內(nèi)固定術(shù)后并發(fā)癥發(fā)生的原因及對策()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年04期
頁碼:
75-77
欄目:
診治失誤案例分析
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
(慈溪市人民醫(yī)院,浙江 慈溪 315300)
Author(s):
GAO YibinTONG Songlin
關(guān)鍵詞:
肩骨折 肱骨骨折 骨折固定術(shù)內(nèi) 手術(shù)后并發(fā)癥
摘要:
目的:探討肱骨大結(jié)節(jié)骨折內(nèi)固定術(shù)后并發(fā)癥發(fā)生的原因及對策。方法:對2010年6月至2020年6月治療的35例內(nèi)固定術(shù)后出現(xiàn)并發(fā)癥的肱骨大結(jié)節(jié)骨折患者的病例資料進(jìn)行回顧性分析。男19例,女16例; 年齡34~67歲,中位數(shù)51歲。初次內(nèi)固定方式為肱骨近端解剖鎖定鋼板內(nèi)固定13例、空心螺釘內(nèi)固定9例、錨釘內(nèi)固定10例、張力帶聯(lián)合錨釘內(nèi)固定3例。初次內(nèi)固定術(shù)后并發(fā)內(nèi)固定失效21例、肩峰撞擊征7例、肩袖再撕裂4例、腋神經(jīng)損傷3例。骨折延遲愈合15例、不愈合2例。根據(jù)初次手術(shù)的內(nèi)固定方式及并發(fā)癥情況,進(jìn)行支具外固定、拆除原內(nèi)固定物、重新內(nèi)固定、修復(fù)肩袖組織等處理,肱骨頭缺損區(qū)均植骨。觀察骨折愈合及肩關(guān)節(jié)功能恢復(fù)情況。結(jié)果:本組35例患者,并發(fā)癥處理采用支具外固定6例、二次手術(shù)29例; 均獲隨訪,隨訪時(shí)間6~23個月,中位數(shù)11個月。骨折延遲愈合或不愈合的17例患者,骨折均愈合,愈合時(shí)間6~14周,中位數(shù)8周。支具去除或二次手術(shù)后6個月,采用美國肩肘外科(American shoulder and elbow surgeons,ASES)評分評價(jià)肩關(guān)節(jié)功能,本組患者肩關(guān)節(jié)ASES評分(80.9±5.7)分。結(jié)論:對于肱骨大結(jié)節(jié)骨折,內(nèi)固定術(shù)后發(fā)生并發(fā)癥主要有忽視對肩關(guān)節(jié)周圍組織損傷的評估和修復(fù)及內(nèi)固定方式不當(dāng)兩大原因。術(shù)前對損傷進(jìn)行全面、準(zhǔn)確的評估,手術(shù)選擇合適的內(nèi)固定方式,重視對肩關(guān)節(jié)周圍組織的修復(fù),有利于減少術(shù)后并發(fā)癥的發(fā)生。對于已發(fā)生術(shù)后并發(fā)癥的肱骨大結(jié)節(jié)患者,根據(jù)初次手術(shù)的內(nèi)固定方式及并發(fā)癥情況,選擇合適的處理方式,可促進(jìn)骨折愈合和肩關(guān)節(jié)功能恢復(fù)。

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備注/Memo

備注/Memo:
基金項(xiàng)目:浙江省醫(yī)藥衛(wèi)生科技計(jì)劃項(xiàng)目(2017KY143)
更新日期/Last Update: 1900-01-01