人工肱骨头置换术治疗老年肱骨近段骨折

Humeral head replacement for fractures of proximal humerus in elderly

目的：探讨人工肱骨头置换术治疗肱骨近端骨折的方法及临床疗效。方法对14例肱骨近端骨折患者（ Neer 分类三部分骨折3例，四部分骨折11例）行人工肱骨头置换术。术后进行功能锻炼。随访并评价治疗效果。结果患者均获随访，时间12～个月。按Neer 评分系统评价疗效：优9例，良4例，差1例，优良率为13/14。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。结论人工肱骨头置换术治疗老年肱骨近段骨折疗效可靠，术后能解除疼痛，稳定和重建关节功能，临床疗效满意。

Objective To explore the arthroplasty in the treatment of proximal humeral fractures and its clinical effi-cacy. Methods 14 consecutive patients with proximal humeral fractures were enrolled in this study,including 3 cases of three-part proximal fractures and 11 cases of four-part proximal humeral fractures by Neer classification. All of the patients were treated by humeral head replacement. The clinical efficacy was evaluated according to the Neer scoring system. Results The patients were followed up for 12 to 24 months. The postoperative Neer score was excellent in 9 cases,good in 4,and poor in 1. The rate of excellent and good was 13/14. No complication was observed in the group such as infection,dislocation or periprosthetic humeral fractures. Conclusions Humeral head replacement is an effi-cient treatment for proximal humeral fractures. It can release pain and restore function.