人工半肩关节置换在肱骨近端骨折治疗中的应用

Hemiarthroplasty for the Treatment of Complex Fractures of Proximal Humerus

目的:探讨人工肱骨头治疗肱骨近端复杂骨折的临床疗效和并发症的预防.方法:12例肱骨近端复杂骨折患者施行人工肱骨头置换术,患者平均年龄64.8岁,1例为三部分骨折,1例为肱骨头劈裂性骨折,10例为四部分骨折,其中3例伴肩关节脱位,手术全部采用可调节式骨水泥型人工肱骨头假体.结果:术后平均随访18.1月,Constant评分平均为78.6分(46～92分).随访发现肱骨大结节上移、肩关节下方不稳定和异位骨化各1例.结论:人工肱骨头置换是治疗肱骨近端复杂骨折的有效方法,精细的手术操作是减少并发症、取得满意疗效的关键.

Objective：To investigate the clinical outcome and prevention of complications of hemiarthroplasty in treatment of the complex fractures of the proximal humerus. Methods：Twelve patients with fracture of proximal humerus were treated. The mean age was 64.8 years. One patient was classified as three - part fracture, one as head - splitting fracture and ten had four - part fractures including three fracture - dislocations. All the patients were treated with modular cemented prostheses. Results：The mean follow - up period was 18.1 months. Constant Scores ranged from 46 - 92 points with an average of 78.6 points. Superior migration of the great tuberosity fragment, inferior instability of the prothesis and hetemtopic ossifieadon each occurred in one patient respectively. Conclusion： Shoulder hemiarthroplasty is an effective therapy for complex fractures of proximal humerus. Meticulous surgical techniques are essential to the prevention of complications and achieving good results.