究半肩关节置换治疗复杂肱骨近端骨折.docVIP

半肩关节置换治疗复杂肱骨近端骨折 刘长路1，刘晓民1，黄 健1，聂慧娟2，马 钢1，丁良甲1 (1内蒙古医科大学第二附属医院关节外科，内蒙古自治区呼和浩特市 010030；2内蒙古医科大学附属医院心血管内科，内蒙古自治区呼和浩特市 010050) 文章亮点： 通过对12例复杂肱骨近端骨折行人工半肩关节置换技术及临床疗效的分析，说明人工半肩关节置换是治疗复杂肱骨近端骨折的有效方法之一。半肩关节置换中肩袖的有效修复和大、小结节的正确重建，以及置换后早期、规范的功能锻炼，是取得满意的临床效果的关键。 关键词： 骨关节植入物；人工假体；半肩关节置换；肱骨近端骨折；肱骨；肱骨骨折 主题词： 肩骨折；肱骨；肱骨骨折；关节成形术，置换 摘要 背景：半肩或全肩关节置换治疗复杂的肱骨近端骨折，在迅速消除患者疼痛、有效恢复关节功能等方面临床疗效较好。 目的：分析人工半肩关节置换治疗复杂肱骨近端骨折的技术方法及临床疗效。 方法：对12例人工半肩关节置换治疗的复杂肱骨近端骨折患者进行疗效分析。按Neer分型：其中，三部分骨折2例，四部分骨折10例。以X射线观察、Neer评分标准对半肩关节置换后肩关节功能进行临床评估。 结果与结论：12例随访时间平均18个月(6-48个月)。Neer评分：优10例，良1例，可1例，优良率92%。随访期X射线显示内假体位置良好，无关节周围骨折、神经损伤、感染、脱位和松动等并发症。说明人工半肩关节置换是治疗复杂肱骨近端骨折的有效方法之一。半肩关节置换中须注意肩袖的有效修复和大、小结节的正确重建，结合置换后早期、规范的功能锻炼，可取得满意的临床效果。 Semi-shoulder arthroplasty for complicated proximal humerus fractures Liu Chang-lu1, Liu Xiao-min1, Huang Jian1, Nie Hui-juan2, Ma Gang1, Ding Liang-jia1 (1Department of Joint Surgery, the Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China; 2Department of Cardiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China) Abstract BACKGROUND: Semi-shoulder or total shoulder arthroplasty for complicated proximal humerus fractures is better in the rapid elimination of pain and restoration of joint function. OBJECTIVE: To analyze the surgical techniques and clinical effects of semi-shoulder arthroplasty on the treatment of complicated proximal humerus fractures. METHODS: The surgical efficacy of 12 cases of complicated proximal humerus fractures who had all received semi-shoulder arthroplasty was analyzed. According to Neer classification, there were two cases of three-part fractures and 10 cases of four-part fractures. X-ray observation and Neer scoring criteria were also used to conduct a clinical evaluation of shoulder joint function after operation. RESULTS AND CONCLUSION: All the patients were followed up for 18 months in average (6 to 48 months). Based