人工肱骨头置换治疗老年肱骨近端三、四部分骨折疗效分析

doi:10.13418/j.issn.1001-165x.2016.01.026

Abstract

Abstract:

Objective　To discuss the indications, surgical methods andclinical efficacy of treating elderly patients’proximal humeral Neer three-part and four-part fractures.　Methods　39 elderly patients with proximal humeral complex fractures received artificial humeral head replacement were analyzed， retrospectively；Postoperative function of the shoulder joint and degree of pain in 15 cases with three-part fractures and 24 cases with four-part fractures, were assessed using neer score of shoulder joint function and VAS score of pain, respectively.　Results　All patients were followed up with follow-up time ranging from 12 to 32 months, with an average of 24 months; Neer score: 15 cases were optimal, 18 cases were good, 5 cases were moderate, 1 case was bad, the excellent rate being 84.6%.　Conclusion　Artificial humeral head replacement for treating elderly patients’ proximal humeral Neer three-part and four-part fractures can get satisfactory curative effect; the key for guaranteeing postoperative clinical efficacy includes correct prosthesis implantation, effective rotator cuff repair, corrective reconstruction of greater and lesser humeral tubercles in operation and individualized early joint functional exercise.

Key words: Artificial humeral head replacement, Proximal humeral fracture, Surgical treatment

References

[1] Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures[J]. Acta Orthop Scand, 2001, 72(4):365-371.
[2] Karataglis D, Stavridis SI, Petsatodis G, et al. New trends in fixation of proximal humeral fractures: a review[J]. Injury, 2011, 42(4):330-338.
[3] Solberg BD, Moon CN, Franco DP, et al. Surgical treatment of three and four-part proximal humeral fractures[J]. J Bone Joint Surg Am, 2009, 91(7):1689-1697.
[4] 黄宇, 莫冰峰, 尹东, 等. 人工肱骨头置换治疗肱骨近端复杂骨折并骨质疏松老年患者的临床疗效[J]. 中国矫形外科杂志, 2014,22(4):308-313.
[5] Heers G, Torchia ME. Shoulder hemi-arthroplasty in proximal humeral fractures[J]. Der Orthopade, 2001, 30(6):386-394.
[6] Cadet ER, Ahmad CS. Hemiarthroplasty for three- and four-part proximal humerus fractures[J]. J Am Acad Orthop Surg, 2012, 20(1):17-27.
[7] Spross C, Platz A, Rufibach K, et al. The PHILOS plate for proximal humeral fractures--risk factors for complications at one year[J]. J Trauma Acute Care Surg, 2012, 72(3):783-792.
[8] 包洪卫, 王青. 肱骨近端骨折人工肱骨头置换的临床解剖研究[J]. 中华医学杂志, 2010, 90(45):3217-3219.
[9] 李菊根, 史群伟, 谢楚海. 肱骨近端粉碎性骨折人工肱骨头置换相关临床解剖因素分析[J]. 中国临床解剖学杂志, 2013,31(4):477-479.
[10] Gartsman GM, Hasan SS. What's new in shoulder and elbow surgery[J]. J Bone Joint Surg Am, 2002，84(1):151-156.
[11] 赵春明, 范卫民, 王青, 等. 肱骨近端解剖测量在人工肩关节置换中的意义[J]. 中国临床解剖学杂志, 2008,26(05):497-499.
[12] 姜春岩, 朱以明, 鲁谊, 等. 人工肱骨头置换术中大结节不同固定方式的稳定性研究[J]. 中华骨科杂志, 2006,26(7):459-463.
[13] Kralinger F, Schwaiger R, Wambacher M, et al. Outcome after primary hemiarthroplasty for fracture of the head of the humerus. A retrospective multicentre study of 167 patients[J]. J Bone Joint Surg Br, 2004, 86(2):217-219.
[14] Krause FG, Huebschle L, Hertel R. Reattachment of the tuberosities with cable wires and bone graft in hemiarthroplasties done for proximal humeral fractures with cable wire and bone graft: 58 patients with a 22-month minimum follow-up[J]. J Orthop Trauma, 2007, 21(10):682-686.
[15] 章军辉, 狄正林, 何志勇, 等. 老年3部分与4部分肱骨近端骨折人工肱骨头置换与内固定治疗的病例对照研究[J]. 中国骨伤, 2010,23(6):435-439.

Clinical efficacy analysis of artificial humeral head replacement for treating elderly patients’proximal humeral Neer three-part and four-part fractures

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