人工肱骨头置换治疗复杂肱骨近端骨折临床疗效分析.docVIP

人工肱骨头置换治疗复杂肱骨近端骨折临床疗效分析【摘要】 目的 探讨人工肱骨头置换治疗复杂肱骨近端骨折的近期临床疗效。方法 对16例复杂肱骨近端骨折行半肩关节置换术，术后按美国肩肘关节医师学会（ASES）肩关节评分系统进行疗效评价,包括术后疼痛、主动活动范围和日常行动功能。结果 所有患者术后均获得随访，随访时间为6月~48月，平均30.1月。患肩ASES评分平均85.6分(64~94分)，VAS疼痛评分平均2.7分(0~5分),肩关节活动度平均为:前曲上举130.1°(90°~150°),外旋35.0°(30°~40°),内旋T10水平。术后1年12例肩关节周围各肌力基本恢复正常，日常生活能力恢复较为满意，3例肩袖肌力不足，外展、上举稍差，无一例出现假体松动、下沉及脱位。结论 人工肱骨头置换术治疗复杂肱骨近端骨折近期疗效满意，但应严格掌握适应证。详细的术前评估?重建肱骨正常长度、确切固定大小结节?可靠有效地重建肩袖?重视术后正规康复训练是提高疗效的关键。? 【关键词】 肱骨骨折； 近端； 人工肱骨头置换?? Humeral head replacement for the treatment of complex proximal humerus fractures analysis of clinical efficacy ZHANG Wei.People?s Hospital of Puer,Puer 665000，China? 【Abstract】 Objective To analysis recent clinical efficacy of humeral head replacement for the treatment of complex proximal humerus fracture.Methods Humeral head replacement for the treatment of 16 complex proximal humerus fracture. American Shoulder and Elbow Surgeons shoulder score criterion was used to evaluate clinical efficacy after operation,including postoperative pain, active range of functions and daily Action functions.Results All patients were followed up from 6-48 months, with an average of 30.1 months. The average ASES score was 85.6 points (64-94),VAS pain score was 2.7(0-5),the average shoulder mobility:before the song on the move 130.1°(90°-150°),external rotation 35.0°(30°-40°),internal rotation T10 level.The muscle around the shoulder returned to normal activities of daily living in 12 patients after 1 year ,satisfied with activities of daily living ,recovery 3 cases of rotator cuff muscle deficiency, outreach,a bit weak on the move,no case of prosthesis loosening,subsidence and dislocation.Conclusion The recent clinical efficacy of humeral head replacement for the treatment of complex proximal humerus fracture was satisfied, but the indications should be strictly controlled.The detailed preoperative evaluation,a detailed reconstruction of the humerus of normal length,exact and reliable fixed-size nodules,very solid reconst