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1、人工肱骨頭置換治療復(fù)雜肱骨近端骨折臨床療效分析【摘要】H的探討人工肱骨頭置換治療復(fù)朵肱骨近端骨折的近期臨床療效。方法對16例復(fù)雜肱骨近端佇折行半肩關(guān)節(jié)置換術(shù)，術(shù)后按美國肩肘關(guān)節(jié)醫(yī)師學(xué)會(ASES)肩關(guān)節(jié)評分系統(tǒng)進(jìn)行療效評價(jià)，包括術(shù)后疼痛、主動活動范圍和日常行動功能。結(jié)果所有患者術(shù)后均獲得隨訪,隨訪時(shí)間為6月~48月,平均30.1月?；技鏏SES評分平均85.6分(64?94分)，VAS疼痛評分平均2.7分(0~5分)，肩關(guān)節(jié)活動度平均為:前曲上舉130.1°(90°?150°),外旋35.0°(30°~4
2、0。)，內(nèi)旋T10水平。術(shù)后1年12例肩關(guān)節(jié)周圍各肌力基本恢復(fù)正簾，H常生活能力恢復(fù)較為滿意，3例肩袖肌力不足，外展、上舉稍差，無一例出現(xiàn)假體松動、下沉及脫位。結(jié)論人工肱骨頭置換術(shù)治療復(fù)雜肱骨近端骨折近期療效滿意，但應(yīng)嚴(yán)格掌握適應(yīng)證。詳細(xì)的術(shù)前評估重建肱骨正常長度、確切固定大小結(jié)節(jié)可靠有效地重建啟袖重視術(shù)后iE規(guī)康復(fù)訓(xùn)練是捉高療效的關(guān)鍵。【關(guān)鍵詞】肱骨骨折；近端；人工肱骨頭置換Humeralheadreplacementforthetreatmentofcomplexproximalhumerusfrac
3、turesanalysisofclinicalefficacyZHANGWei.PeoplesHospitalofPuer,Puer665000,China【Abstract]ObjectiveToanalysisrecentclinicalefficacyofhumeralheadreplacementforthetreatmentofcomplexproximalhumerusfracture.MethodsHumeralheadreplacementforthetreatmentof16comple
4、xproximalhumerusfracture.AmericanShoulderandElbowSurgeonsshoulderscorecriterionwasusedtoevaluateclinicalefficacyafteroperation,includingpostoperativepain,activerangeoffunctionsanddailyActionfunctions.ResultsAllpatientswerefollowedupfrom6-48months,withanav
5、erageof30.1months.TheaverageASESscorewas85.6points(64一94),VASpainscorewas2.7(0~5),theaverageshouldermobility:beforethesongonthemove130.1°(90°-150°),externalrotation35.0°(30°-40°),internalrotationT10level.Themusclearoundtheshoulderreturnedtonormalactivitie
6、sofdailylivingin12patientsafter1year,satisfiedwithactivitiesofdailyliving,recovery3casesofrotatorcuffmuscledeficiency,outreach,abitweakonthemove,nocaseofprosthesisloosening,subsidenceanddislocation.ConclusionTherecentclinicalefficacyofhumeralheadreplaceme
7、ntforthetreatmentofcomplexproximalhumerusfracturewassatisfied,buttheindicationsshouldbestrictlycontrolled.Thedetailedpreoperativeevaluation,adetailedreconstructionofthehumerusofnormallength,exactandreliablefixed-sizenodules,verysolidreconstructionforrotar
8、ycuffofshoulder,effectivelyformalrehabilitationtrainingafteroperationisthekeytoimprovetheefficacy.[Keywords]HumeralFractures；Proximal；Humeralheadreplacement朧骨近端骨折是成人I:肢骨折中常見的類型z-,其屮大部分為無移位或移位不明顯的骨折，通過保守治療即可達(dá)到愈合。肱骨近端
