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.