| 反球式全肩关节置换术治疗老年肱骨近端陈旧性骨折 |
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投稿时间：2019-02-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 叶正从 |
YE Zheng-cong |
杭州市萧山区中医院骨科 浙江中医药大学附属江南医院骨科, 浙江 杭州 311201 |
Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
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| 曹国平 |
CAO Guo-ping |
杭州市萧山区中医院骨科 浙江中医药大学附属江南医院骨科, 浙江 杭州 311201 |
Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
caoguoping008@162.com |
| 汪灿锋 |
WANG Can-feng |
杭州市萧山区中医院骨科 浙江中医药大学附属江南医院骨科, 浙江 杭州 311201 |
Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
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| 韩雷 |
HAN Lei |
杭州市萧山区中医院骨科 浙江中医药大学附属江南医院骨科, 浙江 杭州 311201 |
Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
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| 谢尚举 |
XIE Shang-ju |
杭州市萧山区中医院骨科 浙江中医药大学附属江南医院骨科, 浙江 杭州 311201 |
Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
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| 期刊信息：《中国骨伤》2019年，第32卷，第12期，第1123-1127页 |
| DOI：10.3969/j.issn.1003-0034.2019.12.011 |
| 基金项目: |
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中文摘要:
目的：探讨采用反球式全肩关节置换术治疗老年肱骨近端陈旧性骨折的临床疗效。
方法：自2012年1月至2017年12月行反球式全肩关节置换术治疗12例老年肱骨近端陈旧性骨折患者，男5例，女7例；年龄63~81岁，平均70.2岁；病程9~18个月，平均12.3个月。采用VAS评分评价肩关节疼痛缓解程度，Constant-Murley评分评价肩关节功能改善情况，统计患者术中及术后并发症。
结果：12例全部获得随访，时间15~56个月，平均22.3个月。术后12个月随访时VAS评分（1.9±1.4）分，Constant-Murley评分（83.4±8.4）分；肩关节前屈（92.5±7.7）°，外展（90.4±14.3）°，外旋（31.9±10.0）°，内旋（58.9±13.1）°；术前后差异均有统计学意义（P<0.05）。2例发生肩胛盂切迹，影像学表现分别为Ⅰ级和Ⅱ级，随访未发现松动等表现，无病例发生感染、肩峰骨折、假体松动，腋神经损伤等其他并发症。
结论：反球式全肩关节置换术治疗老年肱骨近端陈旧性骨折可以获得满意的疗效，但应注意适应证及并发症。 |
| 【关键词】关节成形术,置换,肩 肱骨骨折 肩骨折 老年人 |
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| Reverse total shoulder arthroplasty for the treatment of old fracture of proximal humerus in elderly patients |
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ABSTRACT
Objective: To investigate clinical results of reverse total shoulder arthroplasty in treating old fracture of proximal humerus in elderly patients.
Methods: From January 2012 to December 2017,12 elderly patients with old proximal humeral fractures were treated with reverse total shoulder arthroplasty. There were 5 males and 7 females with an average age of 70.2 years old (ranged from 63 to 81 years old) and an average course of 12.3 months (ranged from 9 to 18 months). VAS score was used to evaluate the degree of pain relief of shoulder joint,Constant-Murley score was used to evaluate the improvement of shoulder joint function and observe the complications during and after operation.
Results: All the 12 patients were followed up with an average duration of 22.3 months (ranged from 15 to 56 months). At the latest follow-up,the VAS score was 1.9±1.4,and Constant-Murley score was 83.4±8.4. Among them,shoulder joint flexion was (92.5±7.7)°,abduction was (90.4±14.3)°,external rotation was(31.9±10.0)°,and internal rotation was(58.9±13.1)°. There was statistical significance before and after treatment(P<0.05). There were 2 cases with glenoid notch. The imaging findings were gradeⅠand gradeⅡrespectively. No loosening was found during follow-up. No infection,acromial fracture,prosthesis loosening,axillary nerve injury and other complications occurred.
Conclusion: Reverse total shoulder arthroplasty in treating old proximal humeral fractures in elderly patients can achieve satisfactory results,however,indications and complications should be noted. |
| KEY WORDS Arthroplasty,replacement,shoulder Humeral fractures Shoulder fractures Aged |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 叶正从,曹国平,汪灿锋,韩雷,谢尚举.反球式全肩关节置换术治疗老年肱骨近端陈旧性骨折[J].中国骨伤,2019,32(12):1123~1127 |
| 英文格式: | YE Zheng-cong,CAO Guo-ping,WANG Can-feng,HAN Lei,XIE Shang-ju.Reverse total shoulder arthroplasty for the treatment of old fracture of proximal humerus in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(12):1123~1127 |
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