| 肱骨近端骨折肱骨头置换假体高度的控制 |
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Received:April 19, 2022
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| 期刊信息：《中国骨伤》2022年35卷，第10期，第1000-1003页 |
| DOI：10.12200/j.issn.1003-0034.2022.10.018 |
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目的:评估利用大结节骨折片复位的方法,确定肱骨近端骨折肱骨头置换假体高度的临床疗效。
方法:回顾性研究2015年1月至2019年12月收治并获得随访的肱骨近端骨折患者,符合肱骨头置换指征19例,男7例,女12例;左侧8例,右侧11例;年龄58~84(71.5±5.8)岁;受伤至手术时间3~18(7.9±4.3) d。根据Neer分型,3部分骨折伴脱位2例,4部分骨折17例,其中伴肱骨头脱位6例,肱骨头劈裂2例。19例采用组配式肱骨头假体,在手术过程中,试复位肱骨大结节骨折块,确定肱骨大结节顶点到肱骨标记点的距离,以此距离作为假体高度的标准。术后1年采用Constant-Murley评分,美国加州大学洛杉矶分校(University of California,Los Angeles,UCLA)肩关节评分评价肩关节功能状况及患者满意度。
结果:19例均获随访,时间12~58(31.9±14.2)个月。测量手术后上臂长度26~32 cm,双侧比较误差<0.5 cm。术后3个月肩关节正侧位X线片示骨折均愈合。术后1年Constant-Murley评分(80.8±8.9)分,UCLA评分(27.9±4.8)分。术后1年患者满意度89.5%(17/19)。
结论:肱骨近端骨折肱骨头假体置换手术过程中,试复位肱骨大结节骨折块,确定肱骨大结节顶点到肱骨标记点的距离,以此距离确定假体高度,方法简单准确,临床效果良好。 |
| [关键词]:肱骨近端骨折|关节成形术,置换,肩|外科手术 |
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| Height control in shoulder hemiarthroplasty for treatment of proximal humerus fractures |
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Abstract:
Objective: To evaluate methods of reduction using fragments of the greater tuberosity,and determine the clinical efficacy of humeral head replacement prosthesis height for proximal humerus fractures.
Methods: A retrospective study of patients with proximal humerus fractures who were treated and followed up from January 2015 to December 2019,19 patients met the indications for humeral head replacement,including 7 males and 12 females;8 on the left side and 11 on the right side. The age ranged from 58 to 84 years old with an average of (71.5±5.8) years old. The time from injury to operation 3 to 18 d with an average of (7.9±4.3) d. According to Neer's classification,there were 2 cases of three-part fractures with dislocations and 17 cases of four-part fractures,including 6 cases with dislocation and 2 cases with head splits. All 19 patients used the modular prosthesis. The greater tuberosity fracture fragments were reduced to determine the distance from the apex of the greater tuberosity to the humerus marking point. This distance was used as the standard for the height of the prosthesis. One year after the operation,the Constant-Murley score and the University of California,Los Angeles (UCLA) shoulder score were used to evaluate the functional status of the shoulder joint and patient satisfaction.
Results: The 19 patients were followed up from 12 to 58 months with an average of (31.9±14.2) months. The length of the upper arm was 26 to 32 cm after the operation,two-sided comparison error <0.5 cm. Anteroposterior and lateral X-ray films of the shoulder joint at 3 months after operation showed that the fracture fragments were all healed. After one year follow-up,the Constant-Murley score was 80.8±8.9,and the UCLA score was 27.9±4.8. Patient satisfaction rate was 89.5%(17/19).
Conclusion: The greater tuberosity fracture fragments reduction technique,which use the distance from the apex of the greater tuberosity of humerus to the humeral marking point as the standard for the height of the prosthesis,is a simple and effective way with good outcomes in shoulder hemiarthroplasty for treatment of proximal humerus fractures. |
| KEYWORDS:Proximal humerus fracture|Arthroplasty,replacement,shoulder|Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈为民,张学军,王卫军,王宸.肱骨近端骨折肱骨头置换假体高度的控制[J].中国骨伤,2022,35(10):1000~1003 |
| 英文格式: | CHEN Wei-min,ZHANG Xue-jun,WANG Wei-jun,WANG Chen.Height control in shoulder hemiarthroplasty for treatment of proximal humerus fractures[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(10):1000~1003 |
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