| 人工肱骨头置换治疗老年肱骨近端骨折 |
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Received:August 09, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李瑞琦 |
LI Rui-qi |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 刘进炼 |
LIU Jin-lian |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 刘新晖 |
LIU Xin-hui |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 董威 |
DONG Wei |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 于晓光 |
YU Xiao-guang |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 任立中 |
REN Li-zhong |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 李亚丽 |
LI Ya-li |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 姚龙祥 |
YAO Long-xiang |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 沙子义 |
SHA Zi-yi |
河北医科大学第一医院骨科,河北石家庄050031 |
Department of Orthopeadics,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China |
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| 期刊信息：《中国骨伤》2006年19卷，第7期，第424-425页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨应用人工肱骨头置换治疗老年肱骨近端骨折的疗效。
方法:采用三角肌、胸大肌间隙入路行人工肱骨头置换术治疗老年肱骨近端骨折25例,男12例,女13例;年龄60~92岁,平均75.5岁。按Neer分类标准对肱骨近端骨折进行分型:三部分骨折8例,四部分骨折15例,肱骨头劈裂骨折2例。新鲜骨折21例,陈旧骨折4例。术后第3天行肩、肘、腕、手关节的主动或被动练习。
结果:手术时间45~90min,平均60min,出血量200~300ml。25例手术后均获随访,随访时间1~3年,平均1.5年。所有患者均无感染、神经损伤和假体周围骨折,无假体松动、脱位等并发症。术后根据美国UCLA评分标准:优（34~35分）5例,良（28~33分）16例,中（21~27分）3例,差（0~20分）1例,优良率为84%。术后肩关节活动范围上举为90.5°±6.2°,外旋61.0°±4.5°,内旋75.6°±2.1°。
结论:人工肱骨头置换术是治疗老年肱骨近端骨折较满意的方法,手术时间相对较短,术后功能恢复快,能有效减轻肩关节疼痛。 |
| [关键词]:肱骨骨折 关节成形术,置换 老年人 |
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| Artificial humeral head replacement for the treatment of fractures of proximal humerus in senile patients |
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Abstract:
Objective:To explore therapeutic effects of artificial humeral head replacement for the treatment of fractures of proximal humerus in senile patients.
Methods:Twenty-five patients with fractures of proximal humerus were treated with artificial humeral head replacement.Deltoid muscle and pectoralis major muscle procedure approach were performed in the operation.Among the 25 patients,12 patients were male and 13 female,ranging in age from 60 to 92 years(mean 75.5 years).According to Neer′s classification,8 patients were tris-part fractures,15 patients were quadri-part fractures and 2 patients were split fractures of humeral head.Fresh fractures occurred in 21 patients and old fractures in 4 patients.Initiative and passive exercises of shoulder,elbow,wrist and hand joints performed at the 3st day after operation.
Results:The operation time ranged from 45 to 90 minutes,with an average of 60 minutes,ranging in blood loss from 200 to 300 ml.Twenty-five patients were followed up from 1 to 3 years,with an average of 1.5 years.After surgery,there were no complications such as infection,jnjury of nerve,fractures around prosthesis,loose or dislocation of prosthesis.According to scoring system of UCLA,5 patients achieved excellent result(34-35 scores),16 good(28-33 scores),3 fair(21-27 scores) and 1 poor(0-20 scores).The excellent and good rate was 84%.Postoperative motion range of rising shoulder joint was 90.5°±6.2°,external rotation was 61.0°±4.5°,medial rotation was 75.6°±2.1°.
Conclusion:Artificial humeral head replacement is a satisfactory method for the treatment of fractures of proximal humerus in senile patients,which possess such advantages as shorter operation time,rapid functional recovery,effective shoulder pain releasing. |
| KEYWORDS:Humeral fractures Arthroplasty,replacement 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: | 李瑞琦,刘进炼,刘新晖,董威,于晓光,任立中,李亚丽,姚龙祥,沙子义.人工肱骨头置换治疗老年肱骨近端骨折[J].中国骨伤,2006,19(7):424~425 |
| 英文格式: | LI Rui-qi,LIU Jin-lian,LIU Xin-hui,DONG Wei,YU Xiao-guang,REN Li-zhong,LI Ya-li,YAO Long-xiang,SHA Zi-yi.Artificial humeral head replacement for the treatment of fractures of proximal humerus in senile patients[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(7):424~425 |
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