人工肱骨头置换术治疗老年肱骨外科颈粉碎性骨折临床疗效分析  

Clinical curative effect analysis of artificial humerus head replacement in treatment of elderly patients with humerus surgical neck comminuted fracture

作　　者：刘成日 张鹏[1] 李成福[2] 

机构地区：[1]延边大学临床学院,吉林延吉133000 [2]延边大学附属医院骨关节外科

出　　处：《中国伤残医学》2016年第6期1-3,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨人工肱骨头置换术治疗老年肱骨外科颈粉碎性骨折的临床疗效。方法：回顾性分析2012年6月～2014年6月应用人工肱骨头置换术治疗的16例老年肱骨外科颈粉碎性骨折患者资料，其中男5例，女11例。骨折按Neer分型：3部分骨折6例，4部分骨折10例。记录手术时间和术中出血量。术后根据Neer康复原则进行早期功能锻炼。采用Neer肩关节功能评分标准对其治疗效果进行评定。结果：16例患者均顺利通过手术，手术时间58—96分钟，术中出血量约180～360ml。术后所有患者均获随访，随访时间为6—30个月，平均15个月。患者均无感染、神经损伤、假体周围骨折、假体松动以及脱位等并发症。按Neer肩关节功能评分标准进行评定：优6例，良8例，可2例，差0例；优良率87．5％。结论：人工肱骨头置换术治疗老年肱骨外科颈粉碎性骨折，是一种理想的治疗方法，值得在临床上应用。Objective： To explore the clinical efficacy of artificial humerus head replacement in the treatment of the elderly patients with humerus surgical neck comminuted fracture. Methods： Totally 16 elderly patients （males 5 and females 11 ）with humerus surgical neck comminuted fracture treated by the artificial humerus head replacement were retrospectively analyzed from June,2012 to June,2014. According to the Neer classification, there were 6 cases of three - part fractures and 10 cases of four - part fractures. Recording the opera- tion time and the bleeding volume. Early functional exercise was carried out according to the Neer rehabilitation principles. Its outcome was evaluated by the Neer shoulder joint function score standard. Results： Successful operation was achieved in 16 patients. The operation time was 58 - 96 minutes, the intraoperative blood loss was about 180 -360 ml. All patients were followed up for 6 to 30 months, avera- ging 15 months. The patients had no infection, nerve damage, fracture around the prosthesis, prosthesis loosening, or dislocation and other complications. According to the Neer shoulder joint function score standard, there were excellent in 6 cases, good in 8 cases, fair in 2 case, poor in 0 case. The excellent and good rate was 87.5%. Conclusion： The treatment of humerus surgical neck comminuted fracture in elderly patients with artificial humerus head replacement might be an ideal surgical approach and worthy of clinical application.

关 键 词：人工肱骨头置换术 肱骨外科颈粉碎性骨折 老年患者 

分 类 号：R683.42[医药卫生—骨科学]