人工全肘关节置换治疗老年肱骨远端骨折  

Total elbow replacement in the treatment of distal humeral fractures in the elderly

作　　者：曹家庆[1] 韩欣攸 金翔赟 黄晶焕 李晓林[1] CAO Jia-qing;HAN Xin-you;JIN Xiang-yun;HUANG Jing-huan;LI Xiao-lin(Dept of Orthopaedics,Shanghai Sixth People′s Hospital,Shanghai Jiao Tong University,Shanghai200233,China)

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《临床骨科杂志》2018年第2期230-232,共3页Journal of Clinical Orthopaedics

摘　　要：目的评价人工全肘关节置换治疗老年肱骨远端骨折的临床疗效。方法对31例老年肱骨远端骨折患者行人工全肘关节置换术,采用Mayo肘关节功能评分标准(MEPS)和疼痛VAS评分评价疗效,观察并发症。结果手术时间114~248(162.3±38.7)min,术中出血量138~272(183.8±32.8)ml。3例因心脑血管疾病死亡,1例肺心病死亡,1例失访;26例患者获得随访,时间32~72(49.3±6.2)个月。26例患者切口均一期愈合,无感染、假体松动、骨吸收、脱位、假体柄断裂及假体周围骨折发生。5例发生尺神经麻痹。末次随访时,MEPS评分68~100(89.5±5.8)分,其中优10例,良14例,中2例,优良率为24/26;VAS评分为0~5(1.2±0.5)分。结论人工全肘关节假体治疗老年肱骨远端骨折疗效确切、并发症少。Objective To evaluate the clinical outcomes of total elbow replacement in the treatment of distal humeral fractures in the elderly.Methods The 31 elderly patients of distal humeral fractures were treated with total elbow replacement.The study included:Mayo elbow performance score(MEPS),pain VAS evaluation and complications.Results The operation duration was 114~248(162.3±38.7)min,intraoperative blood loss was 138~272(183.8±32.8)ml.Three patients died of cardiovascular and cerebrovascular diseases,and 1 patient died of chronic cor pulmonale,and 1 patient was lost to follow-up.The 26 patients were followed up for 32~72(49.3±6.2)months.All incisions were primary healing,without infection,prosthesis loosening,bone resorption and dislocation,prosthesis fracture and periprosthetic fractures.There were 5 patients with ulnar nerve paralysis.At the last follow-up,MEPS were 68~100(89.5±5.8),of which 10 cases were excellent,14 cases good and 2 cases fair,and the excellent and good rate was 24/26.Pain VAS was 0~5(1.2±0.5).Conclusions Total elbow replacement with artificial elbow prosthesis is one optimal selection for distal humeral fractures in the elderly,which has the advantages of curative effect and less complications.

关 键 词：全肘关节置换术 肱骨远端骨折 

分 类 号：R683.41[医药卫生—骨科学] R687.4[医药卫生—外科学]