人工肩关节置换治疗复杂肱骨近端骨折的术式选择及影响因素  

Arthroplasty options and affecting factors for the treatment of complex proximal humeral fractures

作　　者：姜春岩[1] 赵阳 Jiang Chunyan;Zhao Yang(Department of Sports Medicine Service,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院运动医学科,100035

出　　处：《中华创伤杂志》2021年第11期973-978,共6页Chinese Journal of Trauma

基　　金：北京市医院管理局“登峰”计划(DFL20180401)。

摘　　要：复杂肱骨近端骨折后肱骨形态受损严重,肱骨头血运破坏程度大、坏死风险高。临床治疗方法多样,但效果不尽相同。以半肩置换及反肩置换为代表的人工肩关节置换在复杂肱骨近端骨折的治疗中占据重要地位,但其适应证选择以及治疗效果始终存在争议。笔者结合现有文献以及自身临床经验,综合考虑年龄、大小结节、肩袖功能、翻修情况等因素,对目前临床存在争议的人工肩关节置换治疗复杂肱骨近端骨折的术式选择及影响因素予以阐述,进一步明确不同术式的适用范围和影响因素,提高治疗效果。Patients with complex proximal humeral fractures suffer from poor bone quality,impaired blood supply of humeral head and a high risk of osteoporosis.With unpredictable clinical outcome,the treatment of complex proximal humeral fractures is challenging.Shoulder arthroplasty including hemiarthroplasty and reverse shoulder arthroplasty plays an essential role in the treatment of proximal humeral fractures.However,the indication and clinical outcome of shoulder arthroplasty are controversial.Combined with literature and authors'own clinical experiences,arthroplasty options and related influencing factors for the treatment of complex proximal humeral fractures are detailed under consideration of patients'age,quality of tuberosities,status of rotator cuff and revision surgery,etc.,which is helpful to define the extent of surgery and improve clinical outcome.

关 键 词：肱骨骨折 关节成形术 置换 肩关节 

分 类 号：R687.3[医药卫生—骨科学]