人工半肩关节置换在肱骨近端骨折治疗中的应用

目的：探讨人工肱骨头治疗肱骨近端复杂骨折的临床疗效和并发症的预防。方法：12例肱骨近端复杂骨折患者施行人工肱骨头置换术，患者平均年龄64．8岁，1例为三部分骨折，1例为肱骨头劈裂性骨折，10例为四部分骨折，其中3例伴肩关节脱位，手术全部采用可调节式骨水泥型人工肱骨头假体。结果：术后平均随访18．1月，Constant评分平均为78．6分（46～92分）。随访发现肱骨大结节上移、肩关节下方不稳定和异位骨化各1例。结论：人工肱骨头置换是治疗肱骨近端复杂骨折的有效方法，精细的手术操作是减少并发症、取得满意疗效的关键。

Hemiarthroplasty for the Treatment of Complex Fractures of Proximal Humerus

s Objective:To investigate the clinical outcome and prevention of complications of hemiarthroplasty in treatment of the complex fractures of the proximal humerus.Methods:Twelve patients with fracture of proximal humerus were treated.The mean age was 64.8 years.One patient was classified as three-part fracture,one as head-splitting fracture and ten had four-part fractures including three fracture-dislocations.All the patients were treated with modular cemented prostheses.Results:The mean follow-up period was 18.1 months. Constant Scores ranged from 46-92 points with an average of 78.6 points. Superior migration of the great tuberosity fragment, inferior instability of the prothesis and heterotopic ossification each occurred in one patient respectively. Conclusion:Shoulder hemiarthroplasty is an effective therapy for complex fractures of proximal humerus. Meticuious surgical techniques are essential to the prevention of complications and achieving good results.