人工肩关节置换术治疗肱骨近端骨折

Arthroplasty in treatment of four-part fracture of the proximal humerus

目的探讨人工肩关节置换术治疗肱骨近端骨折的方法、并发症及疗效。方法对肱骨近端Neer分型4部分骨折12例行人工肩关节置换术,分析期临床疗效。结果本组12例术后随访3～12年,平均8.6年,其中11例无疼痛,1例有静息痛。肩关节活动度在70%以上者8例,在50%～70%之间者3例。1例肩关节活动度小于50%,假体X线示位置较好,其中6例柄中段有透亮区,无临床症状。无感染、松动、关节不稳等并发症发生。结论人工肩关节置换治疗肱骨近端4部分骨折,术后肩关节功能恢复满意,能解除疼痛、稳定关节、重建关节功能,是一种有效的治疗方法。

Objective To explore the arthroplasty in the treatment of 4 part fracture of the proximal humerus and its complications. Methods 12 patients with four part fracture of the proximal humerus by Neer classification were treated by arthroplasty from 1990 to 1999. Results The 12 patients were followed up for an average of 8.6 years, ranging from 3 to 13 years. 11 of the patients were completely relieved of pain, but 1 case still felt pain. 8 had more than 70%of normal range of should motion, 3 had 50%to 70%and 1 less than 50%. X ray films showed good positions of the prosthesis. 6 patients had signs of transparency but no clinical manifestation. No such complications as infection, dislocation or instability occurred. Conclusion Shoulder arthroplasty is a dependable method to restore comfort and function for patients with four part fracture of the proximal humerus.