人工肱骨头置换术治疗老年肱骨近端粉碎性骨折临床分析

Effect of artificial humeral head replacement on proximal humerus comminuted fractures in elderly patients

目的探讨人工肱骨头置换术治疗老年肱骨近端粉碎性骨折的临床疗效。方法对16例60岁以上Neer三、四部分肱骨近端骨折患者采用经三角肌前外侧入路人工肱骨头置换术治疗。结果患者均获随访,时间12个月-24个月。按Neer评分系统评价疗效：优10例,良5例,差1例,优良率为93.7%。假体位置良好,无假体松动和周围骨折等并发症发生。结论人工肱骨头置换术治疗老年肱骨近端粉碎性骨折疗效可靠,术后能解除疼痛,稳定和重建关节功能,临床疗效满意。

Objective To investigate the clinical outcome of artificial humeral head replacement for the treatment of proximal humerus comminuted fractures in elderaly ptients.Methods 16 cases over 60 years old of three or four-part humerus proximal fracture were treated with humeral head replacement by deltoid anterolateral approach.Results The patients were followed up for 12 to 24 months.The postoperative Neer score was excellent in 10 cases,good in 5,and poor in 1.The rate of excellent and good was 93.7%.No complication was observed in the group such as dislocation or peripros thetic humeral fractures.Conclusions Humeral head replacement is an efficient treatment for proximal humerus comminuted fractures.It can release pain and restore function.