人工肱骨头置换术治疗肱骨近端粉碎骨折17例

17 cases of replacement of humeral head Prosthesis for comminuted fractures of proximal humerus

目的 探讨人工肱骨头置换术治疗严重肱骨近端粉碎骨折的临床疗效。方法 2001年5月～2003年10月,应用骨水泥型单极肱骨头假体行人工肱骨头置换术17例,男9例,女8例;年龄38～76岁,平均57.2岁。均为Neer四部分新鲜骨折。结果 随访率100％,至2003年10月,随访5～29个月(平均16.2个月),采用Neer百分制评定标准,本组优10例,良5例,可2例,差0例。结论 人工肱骨头置换术是治疗严重肱骨近端粉碎骨折的一种较好方法,其在减轻创伤后肩关节疼痛和重建肩关节功能方面疗效满意,但应严格掌握手术适应症,提高手术技巧及加强术后康复治疗。

Objective To investigate the clinical outcomes in treating comminuted fractures of proximal humerus by using replacement of humeral head prosthesis. Methods From May 2001 to October 2003, Seventeen patients (9 males and 8 females, age range 38～76 years, mean 57. 2 years) were treated with replacement of cemented humeral head prosthesis. According to Neer classification, all the cases had four--part fracture. Results Until October 2003, all the patients were followed up for 5～29 months after operation (average 16. 2 months). According to the criteria of function evaluation by Neer, excellent 10 cases, good 5 cases, common 2 cases, poor 0 cases. Conclusion Replacement of humeral head prosthesis is a method for treating the comminuted fractures of proximal humerus, with significant effect in relieving the pain and reconstructing the function of shoulder. It is very important about abiding grasp the indication of operation, operation techique and postoperative rehabilitation treatment.