TriGen交锁髓内钉结合缝合锚钉治疗肱骨近端NeerⅢ、Ⅳ型骨折的临床应用

Yin Cui, Xiu-hui Wang, Minghui Wang, Beigang Fu, F. Gao, Wan-gen Guo
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摘要

目的分析TriGen交锁髓内钉结合缝合锚钉治疗NeerⅢ、Ⅳ型肱骨近端内翻骨折的临床疗效。方法2015年6月至2017年6月,应用TriGen交锁髓内钉结合缝合锚技术治疗23例NeerⅢ、Ⅳ型肱骨近端内翻骨折,其中NeerⅢ型15例,NeerⅣ型8例。随访骨折愈合时间。术后1年测量肩关节活动范围。采用美国肩肘外科医生(ASES)评分、Constant Murley评分和视觉模拟评分(VAS)。结果所有患者随访12~16个月,平均14个月。术后2~4个月骨折全部愈合,平均3个月。未发生伤口感染、肩袖损伤、腋神经损伤等并发症。ASES评分、Constant Murley评分和VAS评分分别为(91.00±3.04)、(90.00±3.21)和(0.42±0.38)。结论对于NeerⅢ、Ⅳ型复杂肱骨近端内翻骨折,采用TriGen交锁髓内钉结合缝合锚技术治疗,增加了肱骨结节的固定强度,符合整体固定的理念,有利于早期功能康复,术后效果良好。这是一种可靠的微创治疗方法。关键词:肱骨骨折;外科手术;近端;髓内钉;锚
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Clinical application of TriGen interlocking intramedullary nail combined with suture anchor in the treatment of Neer type III and IV proximal humeral fractures
Objective To analyze the clinical efficacy of TriGen interlocking intramedullary nail combined with suture anchor in the treatment of Neer typeⅢ andⅣ proximal humeral varus fractures. Methods From June 2015 to June 2017, 23 patients with proximal humeral varus fractures of Neer type Ⅲ and Ⅳ were treated with TriGen interlocking intramedullary nail combined with suture anchor technique, including 15 cases of Neer type Ⅲ and 8 cases of Neer type Ⅳ. The fracture healing time was followed up. The range of motion of shoulder joint was measured one year after operation. American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score and visual analogue scale (VAS) were performed. Results All the patients were follow-up for 12 to 16 months, with an average of 14 months. All fractures healed 2 to 4 months after operation, with an average of 3 months. No complications such as wound infection, rotator cuff injury and axillary nerve injury occurred. The ASES score, Constant-Murley score and VAS were (91.00±3.04), (90.00±3.21) and (0.42±0.38) respectively. Conclusion For Neer type Ⅲ and Ⅳ complex proximal humerus varus fractures, TriGen interlocking intramedullary nail combined with suture anchor technique is used to treat it, which increases the strength of fixing the humeral nodules, conforms to the concept of overall fixation, is conducive to early functional rehabilitation, and achieves good results after operation. It is a reliable minimally invasive treatment method. Key words: Humeral fractures; Surgical procedures, operative; Proximal; Intramedullary nail; Anchor
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