人工肱骨头置换治疗复杂肱骨近端骨折

目的：回顾性研究人工肱骨头置换治疗复杂肱骨近端骨折患者的肩关节的情况,以进一步提高疗效。方法：对我院2004年至2007年27例肱骨近端骨折患者采用肱骨头置换术治疗,术中修复关节囊和肩袖,术后随访5～38月,评价其肩关节功能。结果：采用半关节成形改良评分系统SSMH综合评分,优：5例,良：17例,可：5例,优良率：81.5%。肩关节活动：平均前屈上举：96°,外旋：36°,内旋至L2水平。X片示假体无松动断裂,位置良好。结论：对于复杂的肱骨近端骨折,人工肱骨头置换是有效治疗手段,能够最大限度恢复期肩关节活动功能。

Artificial Humeral Head Replacement in the Treatment of Fractures of the Proximal Humerus

Objective： To investigate the surgical outcome of artificial humeral head replacement in the treatment of fractures of the proximal humerus. Methods： Twenty-seven patients with fracture of proximal humerus were treated with artificial humeral head replacement. All the patients were treated with modular cemented prostheses. Results： A follow-up was carried out in the 27 patients for 5 - 38 months. All patients were pain-free and satisfied with the operation results. According to the SSMH of UCLA, excellent results were obtained in 5 patients, good in 17 patients, fair in 5 patients, and the excellent and good rate was 81.5%. The average forward flexion shoulder was 96°, average external rotation was 36°, and internal rotation reached to L2 level. Radiographic analysis revealed superior migration of the greater tubercle in 1 patient, heterotopic ossification in 1 patient, and prosthesis loosening in 1. Conclusion： Artificial humeral head replacement is an effective therapy for fractures of the proximal humerus, with satisfactory joint range of motion fROM） and low complication rates.