| 胡克立,刘运鲁,邹辉,等.半肩关节置换治疗高龄肱骨近端四部分骨折的疗效评价.骨科,2023,14(6): 511-516. |
| 半肩关节置换治疗高龄肱骨近端四部分骨折的疗效评价 |
| Efficacy Evaluation of Shoulder Hemiarthroplasty for Neer Four-Part Proximal Humeral Fractures in the Elderly |
| 投稿时间：2023-05-21 |
| DOI：10.3969/j.issn.1674-8573.2023.06.005 |
| 中文关键词: 老年人 肩关节 肩骨折 肱骨近端骨折 关节成形术，置换，肩 半肩关节置换 临床疗效 |
| 英文关键词: Aged Shoulder joint Shoulder fractures Proximal humeral fracture Arthroplasty, replacement, shoulder Hemiarthroplasty Clinical outcome |
| 基金项目:湖北省自然科学基金一般面上项目（2023AFB1014） |
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| 中文摘要: |
| 目的 评估半肩关节置换治疗高龄肱骨近端四部分骨折的疗效。方法 回顾性分析2018年1月至2021年12月采用半肩关节置换手术治疗的21例高龄肱骨近端四部分骨折的病人资料，其中男4例，女17例，平均年龄76岁（65~89岁）；均为闭合性新鲜骨折；受伤至手术时间平均为5天（3~8天）。采用疼痛视觉模拟量表（VAS）和Constant-Murley肩关节评分评价手术疗效。结果 21例病人切口均一期愈合。所有病人随访时间超过6个月，其中11例病人随访超过24个月，平均随访时间20个月（6~48个月）。21例病人肱骨大、小结节均愈合。术后6个月，21例病人的VAS评分为（1.24±1.22）分；Constant-Murley评分为（81.10±7.16）分，末次随访时进一步提高为（88.45±4.57）分。进一步研究发现，75岁以上病人术后6个月的VAS评分显著低于75岁以下病人［（0.73±0.90）分 vs. （1.80±1.32）分］，Constant-Murley评分也显著低于75岁以下病人［（78.00±6.83）分 vs. （84.50±6.13）分］，差异均有统计学意义（P＜0.05）。结论 半肩关节置换治疗高龄肱骨近端四部分骨折的疗效优良。 |
| 英文摘要: |
| Objective To evaluate the efficacy of shoulder hemiarthroplasty for the treatment of Neer four-part proximal humeral fractures in the elderly. Methods The data of 21 elderly patients with four-part proximal humeral fractures who underwent shoulder hemiarthroplasty from January 2018 to December 2021 were retrospectively analyzed, including 4 males and 17 females, with an average age of 76 years (65-89). All fractures were fresh and close which caused by trauma. The time from injury to surgery was 5 days (3-8 days). Visual analogue scale (VAS) and Constant-Murley shoulder score were used to evaluate the postoperative efficacy. Results All the 21 patients had primary healing. All patients were followed up for more than 6 months, and 11 patients were followed up for more than 24 months, with a mean follow-up period of 20 months (6-48 months). Both large and small humeral nodules healed in 21 patients. At 6th month after surgery, the VAS score of 21 patients was 1.24±1.22; The Constant-Murley score was 81.10±7.16, which was further improved to 88.45±4.57 at the last follow-up. Further research found that patients over 75 years old had significantly lower VAS scores at 6th month after surgery than those under 75 years old (0.73±0.90 vs. 1.80±1.32), and the Constant-Murley score was also significantly lower in patients over 75 years than those under 75 years old (78.00±6.83 vs. 84.50±6.13), with statistically significant differences (P＜0.05). Conclusion Shoulder hemiarthroplasty is effective in treating Neer four-part proximal humeral fractures in elderly patients. |
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