| 反球型人工肩关节置换术治疗合并肩袖损伤的老年粉碎性肱骨近端骨折 |
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Received:November 15, 2018
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| 期刊信息：《中国骨伤》2019年32卷，第1期，第17-21页 |
| DOI：10.3969/j.issn.1003-0034.2019.01.004 |
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目的：探讨采用反球型人工肩关节置换术治疗老年粉碎肱骨近端骨折的临床疗效。
方法：自2017年1月至2017年12月治疗12例老年粉碎性肱骨近端骨折或骨折-脱位患者，根据术前MRI检查以及术中直视下检查确认肩袖损伤诊断，采用反球型人工肩关节假体置换手术治疗。其中男7例，女5例；年龄65~86岁；左侧受累5例，右侧受累7例。观察患者肩关节活动度及术后并发症情况，采用VAS评分评价疼痛缓解程度，并采用UCLA评分评价肩关节功能恢复情况。
结果：12例患者术后获得随访，时间8~18个月。末次随访时患者肩关节活动度：前屈上举90°~150°，外旋为5°~30°，内旋平均为L3水平（S1水平~L1水平）。VAS疼痛评分为0~6分，UCLA评分为18~32分，其中良5例，差7例。所有患者术后均无感染、假体松动、肩峰应力骨折、神经血管损伤等并发症发生。
结论：合并肩袖损伤的老年粉碎肱骨近端骨折采用反球型人工肩关节置换术治疗，术后早期肩关节活动范围恢复良好，疼痛较轻，患者满意度高。 |
| [关键词]:关节成形术,置换,肩 肱骨骨折 骨折,粉碎性 老年人 |
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| Reverse total shoulder arthroplasty for the treatment of comminuted fracture of proximal humerus in elderly patients with rotator cuff injury |
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Abstract:
Objective: To investigate clinical results of reverse total shoulder arthroplasty in treating comminuted fracture of proximal humerus in elderly patients with rotator cuff injury.
Methods: From January 2017 to December 12,12 comminuted fracture or dislocation of proximal humerus elderly patients were diagnosed as rotator cuff injury by preoperative MRI and operative exploration,and treated by reverse total shoulder arthroplasty. Among them,including 7 males and 5 females aged from 65 to 86 years old;5 patients injured on the left side and 7 patients injured on the right side. Range of motion,postoperative complication were observed,VAS score was used to evaluate pain release and UCLA score was used to assess recovery of shoulder joint.
Results: All patients were followed up from 8 to 18 months. At the latest follow-up,shoulder range of motion conditions were as following:forward bend and lifts ranged from 90°to 150°,external rotation ranged from 10°to 30°,internal rotation could reached L3 level(S1-L1),VAS was for 0 to 6 points,UCLA score ranged from 18 to 32 points,5 patients were good and 7 patients were poor. No infection,prothesis loosening,shoulder stress fracture,injury of vessel and nerve occurred.
Conclusion: Reverse total shoulder arthroplasty in treating comminuted fracture of proximal humerus in elderly patients with rotator cuff injury has advantages of early recovery of shoulder joint range of motion,less pain and high patients' satisfactory. |
| KEYWORDS:Arthroplasty,replacement,shoulder Humeral fractures Fractures,comminuted 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: | 张健,黄强.反球型人工肩关节置换术治疗合并肩袖损伤的老年粉碎性肱骨近端骨折[J].中国骨伤,2019,32(1):17~21 |
| 英文格式: | ZHANG Jian,HUANG Qiang.Reverse total shoulder arthroplasty for the treatment of comminuted fracture of proximal humerus in elderly patients with rotator cuff injury[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(1):17~21 |
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