单纯人工肱骨头置换术治疗肱骨近端粉碎性骨折  

Shoulder hemiarthroplasty for the treatment of proximal humeral splintered fracture

作　　者：陈健民[1] 黄炳生[1] 肖立军[1] 陈文贵[1] 廖穗祥[1] 陈立安[1] 

机构地区：[1]广州市番禺区人民医院骨一科,511400

出　　处：《中华关节外科杂志（电子版）》2009年第5期46-48,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨单纯人工肱骨头置换术治疗肱骨近端严重3～4部分骨折的方法及其效果。方法对本组12例肱骨近端粉碎性骨折患者进行了单纯人工肱骨头置换术,其中男5例,女7例,年龄42～67岁,平均(54.3±3.4)岁。按AO骨折分类标准,9例B2型骨折,2例B3型骨折,1例C3型骨折。结果术后随访9～36个月,平均17.2个月。采用Neer标准评定患者肩关节功能,其中4例大于90分,其余均在80分以上。结论对于肱骨近端粉碎性骨折而言,单纯人工肱骨头置换术是一种疗效较好的治疗方法,人工肱骨头假体安装和肱骨大、小结节解剖重建是提高人工肱骨头置换术疗效的关键,并且术中注意修复损伤的肩袖。术后需要求患者积极进行康复训练促进功能恢复。Objective To investigate the shoulder hemiarthroplasty in treatment and effect of 3 or 4 parts fractures of the proximal humerus.Methods Twelve patients with fracture of proximal humerus were treated with modular cemented prostheses within 1 week. Five cases were male and seven cases were female, age from 42 to 67 years old, average （54.3±3.4） years old. According to AO fractures classification, 9 patients were type B2 . 2 patients were type B3, 1 patient was type C3.Results All patients have been followed up for 9-36 months, 17.2 months on average. Clinical outcome was evaluated by Neer scores. 4 patients got over 90 scores, and the rest got over 80 scores.Conclusions The results of the study indicate that shoulder arthroplasty is a dependable method to restore comfort and function for the patients with three-or four-part fracture of the proximal humerus. Proper position of the prosthesis, anatomical reconstruction of the greater and lesser tuberosities and repaire of the injured rotator cuff are the keys for shoulder hemiarthroplasty to improve clinical effect. In post-operation period, active rehabilitation are vital to reconstruct the function of shoulders.

关 键 词：肩关节 肱骨 肱骨骨折 近端 骨折 粉碎性 

分 类 号：R687.3[医药卫生—骨科学]