人工半肩关节置换术治疗肱骨近端4部分骨折脱位的中期随访  

Hemi-arthroplasty for 4-part fracture-dislocation of proximal humerus: a midterm follow-up study

作　　者：桂琦[1] 张亚奎[1] 张星火[1] 曾纪洲[1] 刘亮[1] 朱旭[1] 赵峰[1] 成文浩[1] 裴征[1] 丛晓鹏 Gui Qi;Zhang Yakui;Zhang Xinghuo;Zeng Jizhou;Liu Liang;Zhu Xu;Zhao Feng;Cheng Wenhao;Pei Zheng;Cong Xiaopeng(Department of Bone and Joint Surgery and Sports,Medicine of Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院骨关节与运动医学科,101149

出　　处：《中华肩肘外科电子杂志》2017年第4期278-284,共7页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：潞河医院首都临床特色应用研究培育项目建设(KJ2017 CX040-04)

摘　　要：目的探讨人工半肩关节置换术治疗肱骨近端4部分骨折脱位的手术要点及中期随访结果。方法 2005年2月至2014年2月,首都医科大学附属北京潞河医院完成64例人工半关节肩置换术,其中22例患者术前诊断为"肱骨近端4部分骨折"。对该组患者资料进行回顾性研究,其中男8例,女14例。患者平均年龄70.5岁(61~81岁)。本组均为新鲜骨折。受伤距手术时间5~9 d。分析年龄、肩袖重建方法、植骨量、大小结节愈合情况对肩关节功能恢复的影响。结果本组患者平均随访6年(3~12年)。肩关节Constant评分平均82.5分(72~86分)。术后无关节脱位、不稳定和感染发生。术前3例腋神经损伤,1例正中神经损伤,在术后3~6周恢复。4例患者出现大结节吸收,肩关节Constant评分较低。结论人工半肩关节置换术治疗肱骨近端4部分骨折脱位,肩关节功能恢复满意。大小结节重建的质量、愈合情况、患者年龄、手术技术水平等是影响疗效的重要因素。Background Proximal humeral fracture accounts for 4%-5%of systematic fractures,and approximately 50%of all shoulder injuries.With the aging population of China,the characteristics of elderly patients with osteoporosis make the morbidity of proximal humeral fractures continue to rise,which is common in clinic.The morbidity in elderly patients over 65 years increased year by year.For the comminuted fracture of proximal humerus,the traditional treatment of open reduction and internal fixation or intramedullary nailing has poor shoulder function,high rate of failure and poor clinical efficacy.In recent years,the improvements of shoulder arthroplasty techniques and prosthesis design make the hemi-or total shoulder arthroplasty for the treatment of complex proximal humeral fractures achieve satisfactory clinical curative effect in pain relief and joint function restore.From February 2005 to February 2014,64 cases of complex proximal humeral fractures were treated with shoulder arthroplasty.Among them,22 patients were diagnosed as"4-part proximal humeral fractures"preoperatively.The clinical data of patients in this group were retrospectively analyzed and followed up in order to obtain the midterm outcome of hemi-arthroplasty for 4-part proximal humeral fractures.

关 键 词：人工半肩置换术 肱骨近端 骨折脱位 愈合 肩袖 

分 类 号：R687.4[医药卫生—骨科学]