人工肩关节置换术治疗复杂肱骨近端骨折的临床分析

The clinical analysis for arthroplasty in treatment of complex proximal humeral fractures

目的探讨人工肩关节置换术治疗复杂肱骨近端骨折的方法及临床疗效。方法回顾性分析20例肱骨近端骨折患者,Neer分型3部分骨折4例,4部分骨折16例。均行人工肩关节置换术,术后按Neer评分系统进行疗效评价。结果所有患者随访12～36个月(平均18.6个月)。按Neer评分系统评价临床结果优6例,良11例,可2例,差1例,优良率85%。术后无感染、神经损伤、假体松动和关节周围骨折等并发症发生。假体位置良好。结论人工肩关节置换术疗效可靠,术后能解除疼痛,稳定和重建关节功能,是治疗复杂肱骨近端骨折的有效方法之一。

Objective To explore the arthroplasty in the treatment of complex proximal humeral fractures and its clinical efficacy. Methods 20 consecutive patients with complex proximal humeral fractures were enrolled in this study, including four cases of three-part proximal fractures and 16 cases of four-part proximal humeral fractures by Neer classification. All of the patients were treated by shoulder arthroplasty. The clinical efficacy was evaluated according to the Neer＇ s scoring system. Results The patients were followed up for 18.6 （12 to 36） months in average. The postoperative Neer＇ s score was excellent in six cases, good in 11, fair in two, bad in one. The rate of excellent-to-good was 85%. No complication was observed in the group such as infection, dislocation or periprosthetic humeral fractures. Conclusions Shoulder arthroplasty is an efficient treatment for complex proximal humeral fractures. It can release pain and restore function.