摘要
目的探讨人工肱骨头置换治疗肱骨近端复杂骨折的疗效。方法 2005年1月-2011年1月,采用骨水泥型人工肱骨头置换治疗18例肱骨近端复杂骨折。男8例,女10例;年龄52～84岁,平均71岁。致伤原因:摔伤11例,交通事故伤3例,砸伤4例。伤后至入院时间为2 h～3 d,平均1.5 d。根据肱骨近端骨折Neer分型标准:三部分骨折8例,四部分骨折7例,肱骨头劈裂性骨折3例。合并肩关节半脱位5例,股骨骨折2例,桡骨骨折1例,骨质疏松症11例。结果手术时间60～180 min,平均80 min;术中出血量100～400 mL,平均200 mL。患者术后切口均Ⅰ期愈合,无感染、神经及血管损伤等早期并发症发生。16例患者获随访,随访时间1～6年,平均3年。X线片检查示无假体松动、脱位及异位骨化等并发症发生。术后1年肩关节功能按照Neer评分系统进行评价,获优5例,良8例,可2例,差1例,优良率81.2%。结论人工肱骨头置换治疗肱骨近端复杂骨折能有效解除疼痛、重建关节功能,尤其适宜于术后活动要求不高的老年患者。
Objective To evaluate the clinical results of artifical humeral head replacement in the treatment of compl icated fractures of the proximal humerus. Method Betweei January 2005 and January 2011, 18 patients with proximal humerus fracture were treated with artifical humeral head replacement. There were 8 males and 10 females with a mean age of 71 years （range, 52-84 years）. Fractures were caused by fall ing in 11 cases, by traffic accident in 3 cases, and by bruise in 4 cases. The time between injury and admission was 2 hours to 3 days （mean, 1.5 days）. According to Neer classification, 8 cases had three-part fracture, 7 four-part fractures, and 3 cleavage fracture of humeral head; 5 cases compl icated by shoulder joint subluxation, 2 cases by femoral fracture, 1 case by radial fracture, and 11 cases by osteoporosis. All the patients were treated with modular cemented prostheses. Results The operative time was 60 - 180 min utes with an average of 80 min utes; the blood loss was 100-400 mL with an average of 200 mL. All incisions healed by first intention without infection or neurovascular injury. Sixteen patients were followed up 3 years on average （range, 1 - 6 years）. According to the Neer scores, the results were excellent in 5 cases, good in 8 cases, moderate in 2 cases, and poor in 1 case I year afteroperation. The excellent and good rate was 81.2%. Conclusion Artificial humeral head replacement is a good therapy for patients with compl icated fractures of the proximal humerus, especally for elderly patients.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2012年第2期205-207,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
肱骨近端复杂骨折
人工肱骨头置换
疗效分析
Complicated proximal humerus fracture Artificial humeral head replacement Effectiveness analysis
