摘要目的 探讨手术治疗肩关节骨折后脱位的临床疗效.方法 随访2005年12月-2008年1月手术治疗有完整资料的10例肩关节骨折后脱位的患者,平均随访时间13.5个月(2.5～23.0个月),依据Neer分型,其中两部分骨折脱位2例,三部分骨折脱位5例,四部分骨折脱位3例.所有患者均采用胸大肌、三角肌手术入路,以螺钉、锁定钢板固定骨折端,以不可吸收缝合线或钢丝、钢缆加强固定大、小结节骨折,采用Constant-Murley绝对值评分标准对肩关节功能进行评定.结果 10例骨折均愈合,平均愈合时间为14.3周,VAS疼痛评分平均1.5分,肩关节平均活动度为前屈上举123.5°,外旋66.5°,内旋T12水平;Constant-Murley评分平均为82.5分,未出现肱骨头坏死的征象.结论 手术切开复位内固定治疗肩关节骨折后脱位短期疗效满意,是一种有效的治疗方法.

abstractsObjective To explore clinical therapeutic effect of complex posterior fracture dislocation of the shoulder treated by surgical treatmont. Methods Ten patients with complex posterior fracture dislocation of the shoulder treated by operation had been reviewed with a mean followup period of 13.5 months (2.5 -23.0 months) . By Neer system, two patients were divided into Necr two,five patients were divided into Neer three, three patients were divided into Neer four. A deltoid-poctorul approach was used in all patients. Screws and locking plates were used to stable the bone fracture. The turbercle fragments were sutured with non-absorbable Ethibond No. 5 or cable tension band. Contant-Murley rating system was adopted to evaluated postoperative functions of the shoulder. Result All patients healed with a mean period of 14. 3 weeks. The mean VAS score was 1.5 ,the mean forward flexion was 123.5° ,external rotation 66.5°, internal rotatioin at T12 level;The Constant-Murley score was 82.5. No patients had heed found for any evidence of humeral head necrosis at the latest follow up. Conclusion The short period clinical therapeutic effect of complex posterior fracture dislocation of the shoulder treated by surgical treatment of open reduction internal fixation is satisfactory.