中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (35): 6620-6623.doi: 10.3969/j.issn.1673-8225.2010.35.040

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

人工肱骨头置换治疗老年肱骨近端粉碎性骨折的技术要点

潘昭勋，曲连军，杨晓明，张洪鑫，崔  岩，孙  超   

  1. 解放军第八十九医院骨科关节外科，山东省潍坊市 261021
  • 出版日期:2010-08-27 发布日期:2010-08-27
  • 作者简介:潘昭勋，男，1962年生，山东省寿光市人，汉族，1985年滨州医学院毕业，主任医师，硕士生导师，主要从事关节外科和运动医学研究。 pzxyy@yahoo.com.cn

Technical points of artificial humeral head replacement for the treatment of comminuted fracture of the proximal humerus in elderly patients

Pan Zhao-xun, Qu Lian-jun, Yang Xiao-ming, Zhang Hong-xin, Cui Yan, Sun Chao   

  1. Department of Joint Surgery, the 89 Hospital of Chinese PLA, Weifang  261021, Shandong Province, China
  • Online:2010-08-27 Published:2010-08-27
  • About author:Pan Zhao-xun, Chief physician, Master’s supervisor, Department of Joint Surgery, the 89 Hospital of Chinese PLA, Weifang 261021, Shandong Province, China pzxyy@yahoo.com.cn

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388

被引次数

14

摘要：

背景：采用人工肱骨头置换治疗老年肱骨近端粉碎性骨折可快速恢复肩关节良好的活动功能。但人工肱骨头置换过程中如何重建和恢复肩关节周围软组织平衡，其关键技术值得探讨。
目的：分析人工肱骨头置换治疗老年肱骨近端粉碎性骨折的效果及技术关键。
方法：选择1999-06/2009-01解放军第八十九医院骨科关节外科施行人工肱骨头置换的13例肱骨近端粉碎性骨折患者，男4例，女9例，年龄在69.2(63~78)岁。术中准确复位固定大小结节，假体植入得当，修复肩袖损伤，术后进行康复训练，采用Neer评分标准随访评价治疗效果。
结果与结论：13例患者随访51(9~112)个月，Neer评分标准显示，优6例，良5例，可2例，优良率85%；X射线片示无关节脱位、假体松动或断柄，患者均能完成日常活动，10例主观非常满意，主观满意度为77%。在熟悉肩关节解剖和功能特点的基础上，严格把握手术适应证，遵循肱骨头置换过程中的关键技术方法，置换后落实必不可少的康复训练过程，采用人工肱骨头置换治疗老年肱骨近端粉碎性骨折，可快速恢复肩关节良好的活动功能。

关键词: 肱骨骨折, 近端, 人工置肱骨头置换, 疗效, 老年人, 人工假体

Abstract:

BACKGROUND: Function of shoulder joint can quickly recover using artificial humeral head replacement for comminuted fracture in elderly patients. However, how to reconstruct and recover the equilibrium of surrounding soft tissues during artificial humeral head replacement needs to be explored.
OBJECTIVE: To investigate treatment effectiveness and technical points of the artificial humeral head replacement for treating comminuted fractures of the proximal humerus in elderly patients.
METHODS: Totally 13 patients with comminuted fractures of the proximal humerus were treated by artificial humeral head replacements at the Department of Joint Surgery, the 89 Hospital of PLA, from June 1999 to January 2009 were analyzed, including 4 males and 9 females, aged 69.2 (63-78) years. Intraoperatively, greater tubercle and lesser tubercle were accurately reduced and fixed and prostheses implanted precisely, rotator cuff repaired. Rehabilitation training was begun in proper strength postoperatively. The treatment effectiveness was evaluated by the Neer’s score criteria.
RESULTS AND CONCLUSION: All the thirteen patients were followed up 51 (9-112) months. According to Neer score criteria, the treatment effectiveness was excellent in six cases, good in five cases, mean in two cases and bad in none. The excellent and good rate was 85%. No dislocation of joint and loosening or ruptures of the prothses were showed on radiograph. All patients could fulfill the daily activities, among them, ten patients were satisfied subjectively. Degree of the subjective satisfaction was 77%. The artificial humeral head replacement can quickly restored satisfactory function of the shoulder joints in the elderly patients with comminuted fractures of the proximal humerus on condition of grasp operative indication, follow the technical points, and perform rehabilitation training.

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