半肩关节置换术治疗肱骨近端严重病损

目的:采用半肩关节置换术治疗肱骨近端严重病损,并评定疗效。方法:共36例。19例成人肱骨近端四分骨折。9例肱骨近端低恶性度骨肿瘤,肱骨头坏死8例。均采用骨水泥固定人工肱骨头置换术治疗。术后功能锻炼。定期X线检查,评估假体稳定性和肩关节功能。随访时间为1～8年,平均5年3个月。结果:1例42岁肱骨近端骨肿瘤患者术后2年出现松动;3例肱骨近端四分骨折患者伴有肩关节外旋部分受限和轻度疼痛。其余病例无痛,无松动,肩关节功能满意。结论:与远期结果有关的因素包括准确的手术适应证的选择,正确的手术方法特别是修复骨缺损和肩袖损伤;选择好假体的大小和厚度以及假体安放位置;另一关键因素为合理的功能锻炼。

Hemiarthroplasty Replacement in Severe Proximal Humerus Damages

Objective: To evaluate the outcome of hemiarthroplasty of the shoulder for severe damages of proximal part of humerus. Methods: Thirty-six cases had a hemiarthroplasty of the shoulder, 19 cases of four parts fractures;9 cases of bone tumor, and 8 cases of humeral head osteonecrosis. Cemented stem was used in the cases. Results: The average follow-up Was 5. 3 years(rang: 1 to 8 years). One case of bone tumor had an aseptic loosening 2 years after the operation, 3 cases of four parts fractures had light pain with limited external rotation of the shoulder. There was no pain or prosthetic stems loosening with satisfactory range of motion in other cases. Conclusion:The functional outcome depends on correct case selection,surgical technique and proper rehabilitation.