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中华肩肘外科电子杂志 ›› 2021, Vol. 09 ›› Issue (04) : 289 -292. doi: 10.3877/cma.j.issn.2095-5790.2021.04.001

创新与争鸣

"悬臂-杠杆重建-不稳定"理论——肱骨近端骨折治疗的新理念
张殿英1,()   
  1. 1. 100044 北京大学人民医院创伤骨科;100044 北京,国家创伤医学中心;100044 北京,创伤救治与神经再生教育部重点实验室;300450 天津,北京大学滨海医院骨科
  • 收稿日期:2021-09-15 出版日期:2021-11-05
  • 通信作者: 张殿英
  • 基金资助:
    教育部创新团队项目(IRT_16R01); 北京大学医学部学院建设项目(2020)——国家创伤医学中心(BMU2020XY005-01); 北京大学医学部学院建设项目(2020)——创伤救治与神经再生教育部重点实验室(BMU2020XY005-03)

The theory of "cantilever reconstruction unbalance" ——new concept of treatment for proximal humeral fracture

Dianying Zhang1()   

  • Received:2021-09-15 Published:2021-11-05
  • Corresponding author: Dianying Zhang
引用本文:

张殿英. "悬臂-杠杆重建-不稳定"理论——肱骨近端骨折治疗的新理念[J]. 中华肩肘外科电子杂志, 2021, 09(04): 289-292.

Dianying Zhang. The theory of "cantilever reconstruction unbalance" ——new concept of treatment for proximal humeral fracture[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2021, 09(04): 289-292.

图1 肩关节外展位肱骨头内螺钉受力示意图注:绿色箭头表示近端和远端螺钉的受力方向,近端2枚螺钉产生支撑应力,远端2枚螺钉产生牵张应力
图2 肩关节内收位肱骨头内螺钉受力示意图注:绿色箭头表示近端和远端螺钉的受力方向,近端2枚螺钉产生牵张应力,远端2枚螺钉产生支撑应力
图3 悬臂梁结构(图A)及肱骨近端结构示意图(图B)
[1]
Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review [J]. Injury, 2006, 37(8): 691-697.
[2]
Bergdahl C, Ekholm C, Wennergren D, et al. Epidemiology and patho-anatomical pattern of 2,011 humeral fractures: data from the Swedish Fracture Register [J]. BMC Musculoskelet Disord, 2016, 17:159.
[3]
Handoll HH, Oluvere BJ. Interventions for treating proximal humeral fractures in adults [J]. Cochrane Database Syst Rev, 2010, 12: Cd000434.
[4]
Aaron D, Shatsky J, Paredes JC, et al. Proximal humeral fractures: internal fixation [J]. Instr Course Lect, 2013, 62:143-154.
[5]
Rangan A, Handoll H, Brealey S, et al. Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial [J]. Jama, 2015, 313(10): 1037-1047.
[6]
Handoll HH, Brorson S. Interventions for treating proximal humeral fractures in adults [J].Cochrane Database Syst Rev, 2015, 11: Cd000434.
[7]
李云霞,陈世益. 肩袖的生物力学及其术后康复 [J/CD]. 中国医学前沿杂志:电子版, 2013, 3: 4.
[8]
Cole BJ, Elattrach NS, Anbarl A. Arthroscopic rotator cuff repairs: an anatomic and biomechanical rationale for different suture-anchor repair configurations [J]. Arthroscopy, 2007, 23(6): 662-669.
[9]
Alidousti H, Giles JW, Emery RJH, et al. Spatial mapping of humeral head bone density [J]. Shoulder Elbow Surg, 2017, 26(9):1653-1661.
[10]
王烨明,魏万富. 肱骨近端骨量分布特点的研究进展 [J]. 中国矫形外科杂志, 2021,29(16):1487-1490.
[11]
Hertel R, Hempfing A, Stlehler M, et al. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus [J]. J Shoulder Elbow Surg, 2004, 13(4): 427-433.
[12]
Wang G, Mao Z, Zhang L, et al. Meta-analysis of locking plate versus intramedullary nail for treatment of proximal humeral fractures [J]. J Orthop Surg Res, 2015, 10:122.
[13]
陈云丰. 非锁定和锁定接骨板在上肢骨折中的正确应用 [C].上海:第八届上海国际骨科前沿技术与临床转化学术会议, 2014.
[14]
陈德,李环如,吴胜祥,等. 锁定与非锁定钢板治疗老年肱骨近端骨折的疗效分析 [J]. 安徽医学, 2014, 35(2): 2.
[15]
Hardeman F, Bollars P, Donnelly M, et al. Predictive factors for functional outcome and failure in angular stable osteosynthesis of the proximal humerus [J]. Injury, 2012, 43(2): 153-158.
[16]
Gracitelli ME, Malavolta EA, Assun OJH, et al. Locking intramedullary nails compared with locking plates for two- and three-part proximal humeral surgical neck fractures: a randomized controlled trial [J]. J Shoulder Elbow Surg, 2016, 25(5): 695-703.
[17]
Zhu Y, Yi L, Shen J, et al. Locking intramedullary nails and locking plates in the treatment of two-part proximal humeral surgical neck fractures: a prospective randomized trial with a minimum of three years of follow-up [J]. J Bone Joint Surg Am, 2011, 93(2): 159-168.
[18]
Micic ID, Kim KC, Shin DJ, et al. Analysis of early failure of the locking compression plate in osteoporotic proximal humerus fractures [J]. J Orthop Sci, 2009, 14(5): 596-601.
[19]
Krappinger D, Bizzotto N, Riedmann S, et al. Predicting failure after surgical fixation of proximal humerus fractures [J]. Injury, 2011, 42(11): 1283-1288.
[20]
Claverti P, Adam P, Bevort A, et al. Pitfalls and complications with locking plate for proximal humerus fracture [J]. J Shoulder Elbow Surg, 2010, 19(4): 489-494.
[21]
吴晓明,吴剑宏,王秋根. 肱骨近端骨折髓内钉治疗的老概念与新方法——第三代肱骨近端髓内钉的设计理念和临床实践 [J]. 中华创伤骨科杂志, 2015, (17):920.
[22]
Maier D, Jaeger M, Izadpanah K, et al. Proximal humeral fracture treatment in adults [J]. J Bone Joint Surg Am, 2014, 96(3): 251-261.
[23]
Rothstock S, Plecko M, Kloub M, et al. Biomechanical evaluation of two intramedullary nailing techniques with different locking options in a three-part fracture proximal humerus model [J]. Clin Biomech (Bristol, Avon), 2012, 27(7): 686-691.
[24]
Dilisio MF, Nowinski RJ, Hatzidakis AM, et al. Intramedullary nailing of the proximal humerus: evolution, technique, and results [J]. J Shoulder Elbow Surg, 2016, 25(5): e130-138.
[25]
Plath JE, Kerschbaum C, Seebauer T, et al. Locking nail versus locking plate for proximal humeral fracture fixation in an elderly population: a prospective randomised controlled trial [J]. BMC Musculoskelet Disord, 2019, 20(1): 20.
[26]
Nolan B, Kippe M, Wiater J, et al. Surgical treatment of displaced proximal humerus fractures with a short intramedullary nail [J]. J Shoulder Elbow Surg, 2011, 20(8): 1241-1247.
[27]
Nijs S, An S, Broos P. Intramedullary fixation of proximal humerus fractures: do locking bolts endanger the axillary nerve or the ascending branch of the anterior circumflex artery? A cadaveric study [J]. Patient Saf Surg, 2008, 2(1): 33.
[28]
高丽洁. 肱骨近端四部分骨折内固定术后患者的康复疗效观察 [J]. 中国康复医学杂志, 2021, 36(7): 849-851.
[29]
Kelly BJ, Myeroff CM. Reverse Shoulder Arthroplasty for Proximal Humerus Fracture [J]. Curr Rev Musculoskelet Med, 2020, 13(2): 186-199.
[30]
张殿英,张晓萌,郁凯,等. 重视骨折固定与骨内、外在因素的关系 [J/CD]. 中华肩肘外科电子杂志, 2018, 6(2): 4.
[31]
张殿英,郁凯,杨剑, 等. "杠杆-支点平衡"理论——对股骨转子间骨折治疗的新认识 [J]. 中华创伤杂志, 2020, 36(7): 647-651.
[32]
张殿英. "杠杆-支点重建"理论重新认识股骨转子间骨折内固定的过去和未来 [J]. 中华创伤骨科杂志, 2020, 22(10): 5.
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