半肩关节置换术治疗复杂性肱骨近端骨折的疗效分析  

Treatment of proximal humerus comminuted fractures with semi-shoulder arthroplasty:the outcome analysis

作　　者：蔡丰[1] 刘晓东[1] 刘亮[1] 杨安礼[1] 

机构地区：[1]上海市杨浦区中心医院骨科,上海200090

出　　处：《中国矫形外科杂志》2012年第6期499-501,共3页Orthopedic Journal of China

基　　金：上海市科委自然科学基金项目(编号:11ZR1434100);上海市卫生局科研基金项目(编号:2010117)

摘　　要：[目的]分析应用半肩关节置换术治疗复杂性肱骨近端骨折的适应证、手术方法及临床疗效。[方法]对应用半肩关节置换术治疗的复杂性肱骨近端骨折39例进行回顾性分析,根据Neer分型,三部分骨折5例,三部分骨折合并肩关节脱位3例,四部分骨折27例,四部分骨折合并肩关节脱位4例,采用Neer评分系统对肩关节进行术后功能评估。[结果]本组病例全部得到随访,随访时间6～36个月,平均24个月,Neer评分:优28例,良7例,可4例,优良率83.5%,肩关节平均活动范围:外展100°,外旋30°。[结论]对复杂性肱骨近端骨折行人工半肩关节置换术,术中注意肩袖的有效修复和大小结节正确重建,结合早期关节功能锻炼,治疗效果满意。[Objective]To analyze the indications,methods and the outcome of the semi-shoulder arthroplasty to treat proximal humerus comminuted fractures.[Method]We reviewed 39 patients who had undergone semi-shoulder arthroplasty for treatment comminuted fracture of proximal humerus.By Neer classification,5 cases were three-part fractures,3 three-part fractures plus shoulder dislocation,27 four-part fractures,4 four-part fractures plus shoulder dislocation.The function of the shoulder was evaluated postoperatively according to Neer scores system.[Result]The patients were followed up for an average of 24 months（6 to 36 months）.By Neer scoring system,28 cases were rated as excellent 7 as good and 4 as fair,with an excellent to good rate of 83.5%.The average active shoulder elevation were 100° and external rotation were 30°.[Conclusion]Hemiarthroplasty of shoulder can achieve good results for comminuted fractures of the proximal humerus.Shoulder cuff should be effective repair and tuberosity should be correctly reconstructed during operation with the early shoulder joint exercise postoperation.

关 键 词：肱骨近端骨折 肩关节 关节成形术 

分 类 号：R687.3[医药卫生—骨科学]