Objective: To observe effectivness and safeness of self-made dentation hook plate associated with hot-air balloon technique in treating Mutch Ⅰ or Ⅱ type isolated greater tuberosity fractures of humerus.
Methods: Between January 2016 and December 2018, 15 patients with Mutch Ⅰ or Ⅱ type greater tuberosity fractures were treated with self-made dentation hook plate associated with hot-air balloon technique. There were 9 males and 6 females with an average age of 45.1 years (range, 29-62 years). The injury causes included falling injury in 9 patients and traffic accident injury in 6 patients. According to Mutch classification, 4 cases were MutchⅠ type and 11 cases were Mutch Ⅱ type. There were 7 cases with anterior dislocation of shoulder. The time from injury to operation was 2-10 days (mean, 4.5 days).
Results: All 15 patients were followed up 8-16 months, with an average of 13.5 months. There was no infection of incision, loss of reduction of fracture block, delayed union or nonunion. The average time of fracture union was 6.5 months (range, 4-8 months). One patient had axillary paralysis at 1 day after operation, and was treated with nutritional nerve therapy, the symptoms disappeared after 2.5 months. Three patients had slight subacromial impingement. After fracture healing, the hook plate was taken out in advance, and the pain and abnormal noise disappeared during shoulder abduction. At last follow-up, Costant-Murley score used to evaluate shoulder joint function was 88-100, with an average of 96.8; 8 cases were excellent, 7 cases were good, and the excellent and good rate was 100%. The internal fixator was removed after 8-16 months after the secondary operation with no re-fracture occurred.
Conclusion: The self-made dentation hook plate associated with hot-air balloon technique is a safe and reliable method for the treatment of Mutch Ⅰ or Ⅱ type isolated greater tuberosity fracture of humerus.
目的: 探讨自制齿状钩钢板结合热气球技术治疗 MutchⅠ、Ⅱ型孤立性肱骨大结节骨折的临床效果及安全性。.
方法: 回顾分析 2016 年 1 月—2018 年 12 月收治的 15 例 Mutch Ⅰ、Ⅱ型肱骨大结节骨折患者临床资料。男 9 例，女 6 例；年龄 29～62 岁，平均 45.1 岁。致伤原因：摔伤 9 例，交通事故伤 6 例。MutchⅠ型 4 例，Ⅱ型 11 例。合并肩关节前脱位 7 例。受伤至手术时间 2～10 d，平均 4.5 d。采用自制齿状钩钢板结合热气球技术复位固定治疗。.
结果: 15 例患者均获随访，随访时间 8～16 个月，平均 13.5 个月。无切口感染、骨折块复位丢失、骨折延迟愈合或不愈合发生；骨折愈合时间 4～8 个月，平均 6.5 个月。1 例术后第 1 天即出现腋神经麻痹症状，予以营养神经治疗，2.5 个月后症状消失；3 例出现轻度肩峰下撞击，待骨折愈合后提前取出钢板，患者肩关节外展时疼痛及异响消失。末次随访时，采用 Costant-Murley 评分评价肩关节功能为 88～100 分，平均 96.8 分；获优 8 例，良 7 例，优良率 100%。患者于术后 8～16 个月二次手术取出钢板，无再骨折发生。.
结论: 自制齿状钩钢板结合热气球技术治疗 MutchⅠ、Ⅱ型孤立性肱骨大结节骨折安全、固定可靠，可取得满意临床效果。.
Keywords: Greater tuberosity of humerus; dentation hook plate; hot air balloon technique; isolated fracture.