摘要
目的探讨肿瘤型肱骨头假体置换采用人工补片行肩关节囊重建的方法和临床应用价值。方法6例肱骨近端肿瘤患者中,初次置换4例,假体脱位翻修2例,置换时将Prolene网状补片一端固定在肩胛盂边缘关节囊上,包绕肱骨头后,另一端固定在肿瘤假体为重建肩袖预制的槽孔内,重建肩关节囊,稳定肩关节。结果6例均获随访,时间12～28(21.2±6.4)个月,假体无脱位。肩关节疼痛VAS评分从术前平均7.3分±0.8分降至术后平均3.1分±1.1分。术后肩关节活动度前屈平均68.9°±14.7°,后伸平均27.5°±8.3°,外展平均72.7°±16.6°,肱骨旋转活动度平均22.5°±9.4°。结论人工补片肩关节囊重建能帮助稳定肩关节,其网状结构还便于术中肩袖及肱骨驱动肌肉的重建,并使肿瘤型肱骨头假体保留良好活动度。
Objective To explore the method and clinical effect of reconstruction of joint capsule with artificial prolene PMH, a polypropylene mesh patch on prosthesis replacement of the proximal humerus with malignant tumor. Methods 6 patients of proximal humeral malignant tumor were received artificial humeral head replacment. 4 of them were primary and the other 2 were revision because of dislocation. During the the replacement, we used the prolene PMH to reconstruct the shoulder capsule by suturing one end of PMH to residual capsule around the glenoid and encapsuling the artifial head, then suturing the other end of PMH onto the small holes on the proximal metal arch of artificial humerus. Results All cases were followed up for 12 ～ 28 （ 21.2 ± 6. 4 ） months, and no dislocation were found, shoulder pain measured by VAS were reduced from preoperative mean 7.3 ± 0. 8 to postoperative mean 3.1 ± 1.1 ,postoperative should joint movement were mean 68.9°± 14. 7° for forward flexion, mean 27. 5° ±8. 3° for backward extension, mean 72. 7° ± 16. 6° for abduction and mean 22. 5° ± 9.4° for rotation. Conclusions Reconstruction of capsule by artificial prolene PMH was helpful to stabilize shoulder joint. The mesh structure of PMH facilitated the reconstruction of residual rotator cuff and other muscles that move the humerus, so to retain more function of replaced shoulder joint.
出处
《临床骨科杂志》
2008年第5期421-424,共4页
Journal of Clinical Orthopaedics
关键词
假体置换
骨肿瘤
肱骨
人工补片
prosthesis replacement
bone neoplasms
humerus
prolene PMH
