| 肱骨小结节骨折诊断和治疗的研究进展 |
| Advances in the diagnosis and treatment of fractures of the lesser tuberosity of the humerus |
| 投稿时间：2024-04-07 |
| DOI：10.3969/j.issn.1672-5972.2025.02.001 |
| 中文关键词: 肱骨 小结节骨折 复位 内固定 关节镜 |
| 英文关键词:Humerus Fractures of lesser tuberosity Reduction Internal fixation Arthroscope |
| 基金项目: |
| 作者 | 单位 | 邮编 | | 姚文浩* | 武汉科技大学医学部医学院,湖北 武汉,430000
中国人民解放军中部战区总医院骨科,湖北 武汉,430000 | 430000 | | 刘培钊* | 中国人民解放军中部战区总医院骨科,湖北 武汉,430000 | 430000 | | 黄明 | 中国人民解放军中部战区总医院骨科,湖北 武汉,430000 | 430000 | | 王华松* | 中国人民解放军中部战区总医院骨科,湖北 武汉,430000 | 430000 | | 张宸* | 中国人民解放军中部战区总医院骨科,湖北 武汉,430000 | 430000 |
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| 中文摘要: |
| 肱骨小结节是肱骨近端非常重要的解剖结构，单纯性肱骨小结节骨折是一种罕见的损伤，常以肱骨近端其他部分骨折一并出现。肱骨小结节骨折在临床上有一定的漏诊率，处理不当常常造成患者的肩关节疼痛以及功能受限，是一种不容忽视的损伤。目前，对于其最佳治疗方式尚存在一定的争议，总体可分为保守治疗与手术治疗两种，各自有其相对的适应证，以手术治疗更受到业界推崇。手术治疗大致分为经皮或关节镜复位和固定，经胸大肌－三角肌入路切开复位内固定，固定的方式以钢板、空心钉、锚钉居多。随着微创技术的发展和内固定器械的改进，经皮或关节镜复位固定越来越受到学者们的青睐，尤其是单纯性小结节骨折；对于小结节粉碎性或小结节合并肱二头肌长头腱脱位者，则更推荐行切开复位内固定术。本文将分析肱骨小结节骨折的发病机制、分型及临床表现，对其治疗方式进行总结和展望，以供临床治疗参考。 |
| 英文摘要: |
| The lesser tuberosity of the humerus is a very important anatomical structure of the proximal humerus. Simple fracture of the lesser tuberosity is a rare injury, often associated with other fractures of the proximal humerus. This fracture has a certain rate of missed diagnosis in clinical practice. Improper treatment often causes shoulder pain and functional limitation, which is a kind of injury that cannot be ignored. At present, there is still some controversy about the best treatment, which can be divided into conservative treatment and surgical treatment, each of which has its own relative indications, and surgical treatment is more favored by the industry. The surgical treatment can be divided into percutaneous or arthroscopic reduction and fixation, open reduction and internal fixation through the pectoralis major and deltoid muscle approach, and the fixation methods are mainly steel plate, hollow screw, and anchor. With the development of minimally invasive techniques and the improvement of internal fixation devices, percutaneous or arthroscopic reduction and fixation has been increasingly favored by scholars, especially for simple lesser tuberosity fractures. Open reduction and internal fixation is recommended for patients with comminuted small nodules or small nodules combined with dislocation of the long head of biceps brachii tendon. This article will analyze the pathogenesis, classification and clinical manifestations of lesser tuberosity fractures of the humerus, summarize and prospect its treatment methods, so as to provide reference for clinical treatment. |
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