反球型人工肩关节置换术治疗老年肱骨近端粉碎性骨折的效果探讨

Objective:To explore the effect of reverse ball artificial shoulder arth roplasty in the treatment of comminuted proximal humerus fractures in the elderly

目的:探讨并分析用反球型人工肩关节置换术对老年肱骨近端粉碎性骨折患者进行治疗的临床效果。方法:选择2018年10月至2019年10月山西医科大学第二医院收治的11例老年肱骨近端粉碎性骨折患者作为研究对象。对这些患者均进行反球型人工肩关节置换术,然后观察其治疗的效果及各项临床指标。结果:术后7 d,这11例患者的VAS评分低于术前,差异有统计学意义(P<0.05)。术后1个月,这11例患者美国加州大学(UCLA)肩关节评分系统中的主动前驱活动度评分和前驱力量评分均高于术前,差异有统计学意义(P<0.05)。术后,这11例患者均未出现假体松动、肩峰应力性骨折、感染、神经血管损伤、肩胛骨撞击等并发症。术后6个月,这11例患者患肩功能的优良率为100%。结论:用反球型人工肩关节置换术对老年肱骨近端粉碎性骨折患者进行治疗可取得良好的效果,能有效地改善其患肩的功能,且其术后的并发症较少,手术的安全性较高。

Objective:To investigate and analyze the clinical effect of the treatment of comminuted fractures of the proximal humerus in elderly patients with backball type artificial shoulder joint replacement.Methods:Eleven elderly patients with comminuted fractures of the proximal humerus admitted to the Second Hospital of Shanxi Medical University from October 2018 to October 2019 were selected as study subjects.All these patients were treated with reverse ball type artificial shoulder joint replacement,and then the therapeutic effect and various clinical indicators were observed.Results:VAS scores of the 11 patients were lower than those before surgery 7 days after surgery,and the difference was statistically significant(P<0.05).One month after the surgery,the active prodromal activity score and prodromal strength score in the shoulder joint scoring system of the University of California(UCLA)of these 11 patients were higher than those before surgery,and the difference was statistically significant(P<0.05).Postoperative complications such as prosthesis loosening,stress fracture of acromial peak,infection,neurovascular injury and scapula impingement were not found in these 11 patients.Six months after the operation,the excellent and good rate of shoulder function in these 11 patients was 100%.Conclusion:The treatment of comminuted proximal humerus fractures in elderly patients with backball type artificial shoulder joint replacement can achieve good results,can effectively improve the function of the affected shoulder,and its postoperative complications are less,the surgical safety is higher.