半肩关节置换术治疗骨质疏松性肱骨近端粉碎性骨折26例

发布时间：2018-05-04 02:45

本文选题：肱骨近端骨折 + 肱骨近端粉碎性骨折　；参考：《山东医药》2017年07期

【摘要】：目的观察半肩关节置换术治疗骨质疏松性肱骨近端粉碎性骨折的临床效果。方法 26例高龄(年龄60岁)骨质疏松性肱骨近端粉碎性骨折患者,均采用半肩关节置换术联合抗骨质疏松药物治疗。出院后每隔3个月随访1次。观察患者术后大小结节骨性愈合情况、肩关节假体位置。术后6个月采用双能X线测量患者左股骨颈骨密度。末次随访时采用肱骨近端骨折Neer评分及Constant评分系统评价患者肩关节功能。结果本组均得到随访,随访时间6~60个月,平均34.2个月。影像学检查所有患者大小结节均骨性愈合,假体无松动、下沉、脱位。术前及术后6个月患者左股骨颈骨密度分别为(0.67±0.05)、(0.87±0.07)g/cm2,二者相比,P0.05。末次随访时26例患者Neer评分为优15例、良8例、可3例、优良率88.5%;术前及末次随访时Constant评分分别为(63.2±5.4)、(66.8±6.5)分,二者相比,P0.05。结论半肩关节置换术治疗骨质疏松性肱骨近端粉碎性骨折效果较好。
[Abstract]:Objective to observe the clinical effect of hemishoulder arthroplasty in the treatment of osteoporotic proximal humeral comminuted fracture. Methods 26 cases of osteoporotic proximal humeral comminuted fracture were treated with hemishoulder arthroplasty combined with anti-osteoporosis drugs. The patients were followed up every 3 months after discharge. The bone healing and the position of shoulder prosthesis were observed. Bone mineral density (BMD) of left femoral neck was measured 6 months after operation by dual energy X ray. At the last follow-up, Neer and Constant scoring system were used to evaluate the shoulder function of patients with proximal humerus fracture. Results all patients were followed up for 6 ~ 60 months (mean 34.2 months). All patients had bony healing and no loosening, sinking and dislocation of the prosthesis. The bone mineral density of left femoral neck was 0.67 卤0.05 卤0.87 卤0.07 g / cm ~ 2 before operation and 6 months after operation, respectively. At the last follow-up, the Neer scores of 26 patients were excellent in 15 cases, good in 8 cases, fair in 3 cases, and excellent and good rate 88.5.The Constant scores before and at the last follow-up were 63.2 卤5.4 卤6.5, respectively (P 0.05). Conclusion half shoulder arthroplasty is effective in treating osteoporotic proximal humerus comminuted fracture.
【作者单位】：承德医学院附属医院;承德市中心医院;
【分类号】：R687.4;R580

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