移位性肱骨近端四部分骨折人工肱骨头置换及术后早期个体化康复治疗

目的探讨人工肱骨头置换结合术后个体化康复手段治疗移位性肱骨近端四部分骨折的临床疗效,为基层医院开展肱骨近端复杂骨折治疗提供临床经验。方法对9例移位性肱骨近端四部分骨折患者施行人工肱骨头置换,并于术后给予个体化康复治疗,采用Constant评分进行临床效果评估。结果术后随访5～24个月,平均15.4个月。手术前和末次随访时的Constant评分分别为（14.5±6.5）分和（80.5±5.6）分。结论人工肱骨头置换是治疗移位性肱骨近端四部分骨折的有效方法,正确选择适应证、术中精细操作、术后进行个体化康复锻炼是减少并发症和取得满意疗效的关键。

Humeral head replacement and individualized rehabilitation for displaced four-part fractures of proximal humerus

Objective To investigate the clinical outcome of humeral head replacement and individualized rehabilitation for displaced four-part fractures of proximal humerus, to provide clinical guideline of treating complicated fractures of proximal humerus at the basic level hospitals. Methods Nine patients with displaced four-part fractures of the proximal humerus were treated by artificial humeral head replacement with postoperative individualized rehabilitation. Clinical results were evaluated according to the Constant scores. Results All cases were followed-up from 5 to 24 months （average 15.4 months）. Constant scores at the last follow-up improved from 14.5 ± 6.5 to 80.5 ± 5.6. Conclusions Humeral head replacement and individualized rehabilitation for displaced four-part fractures of proximal humerus is an effective therapy for complex fractures of proximal humerus.