半肩关节置换治疗复杂肱骨近端骨折  

Semi-shoulder arthroplasty for complicated proximal humerus fractures

作　　者：刘长路[1] 刘晓民[1] 黄健[1] 聂慧娟[2] 马钢[1] 丁良甲[1] 

机构地区：[1]内蒙古医科大学第二附属医院关节外科,内蒙古自治区呼和浩特市010030 [2]内蒙古医科大学附属医院心血管内科,内蒙古自治区呼和浩特市010050

出　　处：《中国组织工程研究》2013年第52期8987-8992,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:半肩或全肩关节置换治疗复杂的肱骨近端骨折,在迅速消除患者疼痛、有效恢复关节功能等方面临床疗效较好。目的:分析人工半肩关节置换治疗复杂肱骨近端骨折的技术方法及临床疗效。方法:对12例人工半肩关节置换治疗的复杂肱骨近端骨折患者进行疗效分析。按Neer分型:其中,三部分骨折2例,四部分骨折10例。以X射线观察、Neer评分标准对半肩关节置换后肩关节功能进行临床评估。结果与结论:12例随访时间平均18个月(6-48个月)。Neer评分:优10例,良1例,可1例,优良率92%。随访期X射线显示内假体位置良好,无关节周围骨折、神经损伤、感染、脱位和松动等并发症。说明人工半肩关节置换是治疗复杂肱骨近端骨折的有效方法之一。半肩关节置换中须注意肩袖的有效修复和大、小结节的正确重建,结合置换后早期、规范的功能锻炼,可取得满意的临床效果。BACKGROUND：Semi-shoulder or total shoulder arthroplasty for complicated proximal humerus fractures is better in the rapid elimination of pain and restoration of joint function. OBJECTIVE：To analyze the surgical techniques and clinical effects of semi-shoulder arthroplasty on the treatment of complicated proximal humerus fractures. METHODS：The surgical efficacy of 12 cases of complicated proximal humerus fractures who had al received semi-shoulder arthroplasty was analyzed. According to Neer classification, there were two cases of three-part fractures and 10 cases of four-part fractures. X-ray observation and Neer scoring criteria were also used to conduct a clinical evaluation of shoulder joint function after operation. RESULTS AND CONCLUSION：Al the patients were fol owed up for 18 months in average （6 to 48 months）. Based on Neer scoring, excellent was in 10 cases, good in one case, fair in one case. The excellent rate was 92%. During the fol ow-up period, prosthesis location was good and there were no complications, such as periarticular fractures, nerve injury, infection, dislocation or looseness. Attention should be paid for the effective restoration of shoulder cuff and the correct reconstruction of the large and smal nodules in semi-shoulder arthroplasty. Besides, it also should be combined with the early and standard functional exercises. The clinical effect of semi-shoulder arthroplasty is satisfactory and it is an effective way to treat complicated proximal humerus fractures.

关 键 词：骨关节植入物 人工假体 半肩关节置换 肱骨近端骨折 肱骨 肱骨骨折 

分 类 号：R318[医药卫生—生物医学工程]