摘要
目的探讨半肩置换术治疗肱骨近端粉碎性骨折的手术关键技术及评估手术效果。方法选取本科室符合条件的患者共17例。均为粉碎性骨折,Neer分类为四部分骨折或三部分骨折患者。合并肩关节脱位4例,骨质疏松6例。均采用骨水泥固定人工肱骨头置换术治疗。术后指导康复锻炼。定期复查,并使用Neer肩关节功能评分系统评估手术效果。结果 17例均获随访4～34个月,平均12个月。术后6个月Neer评分6例优,9例良,2例可,平均分为86.9分,优良率达88.2%,其疼痛、功能、运动范围各项指标在治疗前后的差异均有统计学意义(P<0.05)。2例患者术后伴有肩关节外展、上抬时轻度疼痛。其余病例无疼痛,无假体松动,肩关节功能恢复满意。结论手术成功关键包括手术适用证的准确把握;假体的选择及准确放置;假体周围软组织的重建及平衡;术后合理的功能锻炼。
Objective To investigate the key technologies of hemiairthroplasty of proximal humerus comminuted fractures and evaluate the operation effect.Methods Seventeen cases in our hospital had a hemiarthroplasty of the shoulder,of which with four-part or three-part proximal humerus fractures.There were 4 cases of shoulder dislocation and 6 cases of osteoporosis.Cemented stem was used in every case.Every patient was received the postoperative functional exercise guidance.We use Neer functional score system to evaluate the effect of operation after regular follow-up.Results The average follow-up was 12 months（range：4 to 34 months）.According to Neer functional score system,excellent and good rate was 88.2% and population mean score was 86.9 six months after operation.The difference of pain,function,range of motion before and after operation in Neer Score was statistically significant（P＆lt;0.05）.Two cases had light pain in abduction and elevation.There was no pain or prosthetic stems loosening with satisfactory range of motion in other cases.Conclusion The keys to successful operation are correct case selection,choice of prosthesis and accurate placement,and keeping balance of soft tissues and proper rehabilitation.
出处
《安徽医学》
2013年第5期557-560,共4页
Anhui Medical Journal
关键词
肩关节置换
肱骨头置换
骨折
Shoulder replacement
Humeral head replacement
Fracture
