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目的 比较肩关节外侧微创入路与传统的肩关节前内侧入路对肱骨外科颈骨折患者腋神经的影响.方法 将104例肱骨外科颈骨折患者随机均分为肩关节外侧微创入路组(A组)和传统的肩关节前内侧入路组(B组),比较两组手术时间、术后肩关节功能评分以及腋神经损伤情况.结果 术后1年随访,两组患者骨折均愈合,无感染迹象.与B组相比,A组手术时间缩短[(82.0±23.1)min vs.(126.7±19.4)min],术后肩关节功能评分增加[(88.4±5.6) 分vs.(79.7±5.7) 分](P<0.01).A组术后3d的腋神经损伤发生率高于B组(30.8% vs.23.1%)(P0.05).结论 与传统的肩关节前内侧入路比较,采用肩关节外侧微创入路治疗肱骨外科颈骨折,具有手术时间短、创伤小和肩关节功能恢复快等优势.术后近期,肩关节外侧微创入路的一过性腋神经损伤发生率稍高,但1年后与传统的肩关节前内侧入路相仿.“,”Objective To compare the effect of two surgical approaches of lateral minimally invasive approach and traditional anterior approach on the axillary nerve in the surgery of surgical neck fracture of humerus.Methods A total of 104 patients with surgical neck fracture of humerus was equally randomized into two groups of A(operated via lateral minimally invasive approach of shoulder joint) and B(operated via conventional anterior approach).The operation time,score of shoulder joint function and incidence of axillary nerve injury after operation were compared between two groups.Results All the fractures were healed without infection during 1-year follow-up.Compared with group B,the operation time was shorter[(82.0±23.1) minutes vs.(126.7±19.4) minutes],and the score of shoulder joint function after operation was more[(88.4±5.6) points vs.(79.7±5.7) points] in group A (P<0.01).The incidence of axillary nerve injury in the 3rd day after operation in group A was significantly higher than that in group B(30.8% vs.23.1%)(P0.05).Conclusion Compared to conventional anterior approach for the surgery of surgical neck fracture of humerus,lateral minimally invasive approach has the advantages of shorter operation time,less trauma and quicker recovery of shoulder joint function.The incidence of transient axillary nerve injury in a short-term is higher via lateral minimally invasive approach than that via conventional anterior approach,which of two approaches is similar one year after surgery.