人工肱骨头置换术后早期康复训练方法探析  

Postoperative rehabilitation for hemi-arthroplasty of the shoulder

作　　者：吕泽斌[1] 胡晓梅[1] 林砚铭[1] 董万涛[2] 尉伟卫[1] 李磊[1] 

机构地区：[1]成都中医药大学临床医学院,610072 [2]甘肃中医学院附属医院关节外科,兰州730000

出　　处：《中华肩肘外科电子杂志》2014年第3期174-177,共4页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的：探讨人工肱骨头置换术后早期康复训练对肩关节功能恢复的效果。方法自2010年2月至2013年6月，对11例严重肩关节损伤患者行人工肱骨头置换术。男性3例，女性8例；年龄46~73岁，平均52.1岁。致伤原因：肱骨近端骨折9例，肱骨头缺血性坏死1例，肱骨近端骨巨细胞瘤1例。手术由同组医师完成，术后早期开始康复训练，采用改良 UCLA 评分表评定治疗效果。结果1例患者于术后6个月死于肿瘤全身转移，其余10例平均随访15.4个月(12~40个月)。改良 UCLA 评分：优8例，良2例，差0例。结论早期进行康复训练维持重建关节的活动度，促进肌力恢复，改善关节功能，在人工肱骨头置换术远期疗效中发挥关键作用。Background As the artificial joint technology and material become matured gradually,the humeral head replacement starts to play an important role in the clinical treatment of severe lesion of shoulder joint,which can effectively relieve pain and recover the passive range of motion of the shoulder joint after operation,but its active motion still depends on the shoulder muscle strength,so the early postoperative rehabilitation training has become the key treatment measures after the humeral head replacement.This paper discusses the effect of early rehabilitation training on the shoulder joint recovery after artificial humeral head replacement.Methods From February 2010 to June 2013,11 cases of severe shoulder joint lesion received the artificial humeral head replacement operation.Among them,3were males,8were females;aged 46 to 73years old,averagely 52.1years old.The cause of injury:9cases of proximal humeral fractures,1case of ischemic necrosis of the humeral head and 1case of giant cell tumor of proximal humerus.With the contralateral shoulder as control,preoperative routine anteroposterior,oblique and axillary plain X-ray of shoulder joint were required,and also the shoulder MRI examination,in order to assess the damage of skeletal and soft tissue.Use the beach chair position under general anesthesia.Then routinely do the skin preparation and draping.We take the deltoid and pectoralis major muscle interval approach,then release the deltoid along the shaft of humerus,and retract the conjoint tendon medially,incise the subscapularis tendon and the anterior capsule,adjust the hypsokinesis angle according to the joint stability,cut off it and measure the diameter of humeral head to determine the size of prosthesis,carefully clean the broken ends of the proximal humerus fracture patients.Install the suitable size of test model after largening the medullary cavity,check the ROM and soft tissue tension after the reduction of the shoulder.Remove the template if it is ideal,pulse flushing the medullary cavity,use the bon

关 键 词：肱骨骨折 近端 肩关节 肱骨头置换术 人工 康复 

分 类 号：R473.6[医药卫生—护理学]