CAJ | 학술논문

目的：探讨分析关节镜在治疗肩关节脱位合并肱骨大结节骨折时的近期临床效果。方法回顾性分析广东省清远市人民医院骨科自2013年11月到2014年11月之间收治的肩关节脱位合并肱骨大结节骨折的患者16例，其中男性有10例，女性6例，年龄从36～68岁，平均年龄为（46±2）岁。所有患者均有明确的受伤史；其中有14例患者为摔伤，有2例患者为坠落伤；有12例为左侧肩部受伤，有4例为右侧肩部受伤；然后对所有患者采取关节镜下进行修复，其中有6例患者为完全关节镜下修复，有10例为采取关节镜下辅助小切口进行修复。结果经治疗后，所有患者切口均达到Ⅰ期愈合标准，未出现伤口感染、出血等并发症。术后2～6个月内对患者行X线片检查，发现肱骨大结节骨折的愈合从3～6月，平均为4.1个月。对所有患者均进行了定期（每半年1次，共3次）随访观察。术后第6个月随访时，有3例患者出现肩关节外展，外旋活动轻度受限，有1例患者出现前屈活动受限；有1例患者出现前屈时疼痛。后经积极的康复训练，均恢复良好。所有患者肩关节未出现再次脱位。采用Constant－Murley肩关节评分系统为（32.88±4.12）分；本组优11例，良4例，可1例，优良率93.75％。结论临床上，在治疗肩关节脱位合并肱骨大结节骨折时采用关节镜技术不仅手术创伤小，术后恢复快，而且治疗效果满意，与保守治疗相比并发症少，值得临床医生学习推广。
목적：탐토분석관절경재치료견관절탈위합병굉골대결절골절시적근기림상효과。방법회고성분석광동성청원시인민의원골과자2013년11월도2014년11월지간수치적견관절탈위합병굉골대결절골절적환자16례，기중남성유10례，녀성6례，년령종36～68세，평균년령위（46±2）세。소유환자균유명학적수상사；기중유14례환자위솔상，유2례환자위추락상；유12례위좌측견부수상，유4례위우측견부수상；연후대소유환자채취관절경하진행수복，기중유6례환자위완전관절경하수복，유10례위채취관절경하보조소절구진행수복。결과경치료후，소유환자절구균체도Ⅰ기유합표준，미출현상구감염、출혈등병발증。술후2～6개월내대환자행X선편검사，발현굉골대결절골절적유합종3～6월，평균위4.1개월。대소유환자균진행료정기（매반년1차，공3차）수방관찰。술후제6개월수방시，유3례환자출현견관절외전，외선활동경도수한，유1례환자출현전굴활동수한；유1례환자출현전굴시동통。후경적겁적강복훈련，균회복량호。소유환자견관절미출현재차탈위。채용Constant－Murley견관절평분계통위（32.88±4.12）분；본조우11례，량4례，가1례，우량솔93.75％。결론림상상，재치료견관절탈위합병굉골대결절골절시채용관절경기술불부수술창상소，술후회복쾌，이차치료효과만의，여보수치료상비병발증소，치득림상의생학습추엄。
Objective To investigate the clinical effect of arthroscopic treatment for the treatment of the fractures of the shoulder and joint of the humerus with large fractures of the humerus.Methods A retrospective analysis in our hospital since November 2013 to November 2014 from shoulder joint dislocation with humeral greater tuberosity fracture patients, 16 cases in which males have 10 cases, 6 cases of women, age from 36~68 years old, the average age for age (46+2).All patients had a clear history of injury.Among them, 14 patients falls, 2 patients was injured by falling; 12 cases of left shoulder injury, 4 cases of right shoulder injury; then of all patients were treated with arthroscopic repair, including 6 cases of patients with complete arthroscopic repair, 10 cases for taking arthroscopically assisted small incision to repair.Results After treatment, all the patients reached the first phase healing standards, and there were no complications such as wound infection and bleeding.The X-ray examination was performed in patients with 2~6 months, and the healing of the large fractures of the humerus was from 3~6 months to 4.1 months.A total of patients were regularly (1 times a year, a total of 3) follow-up observation.In the 6 months follow-up after operation, 3 cases of patients with shoulder abduction and external rotation slightly limited, limited flexion activities were seen in 1 case, 1 cases of flexion in patients with pain.After the rehabilitation training, the recovery of good.There was no dislocation of shoulder joint in all patients..Constant-Murley shoulder joint scoring system was (32.88 ±4.12).The group was excellent in 11 cases, good in 4 cases, and available in 1 cases, the fine rate was 93.75%.Conclusion In the treatment of shoulder dislocation combined with humeral greater tuberosity fractures using arthroscopic technique not only small surgical trauma, postoperative quick recovery, and the curative effect is satisfactory, compared with the conservative treatment, fewer complications, it is worth learning generalization clinicians.