CAJ | 학술논문

目的：探讨半肩关节置换治疗老年肱骨近端复杂骨折的方法及临床疗效。方法对15例行人工半肩关节置换术的老年肱骨近端骨折患者进行回顾分析，平均年龄67.0岁，按Neer分型：三部分骨折2例，四部分骨折13例。根据Neer评分系统对半肩关节置换术后肩关节进行功能评估。结果所有患者均获随访，随访时间9～36个月，平均25个月。按Neer评分：优4例，良9例，可2例，优良率80％，肩关节活动范围平均为：前屈上举95°，后伸30°，外展80°，内收20°，外旋20°，内旋30°。全部患者无假体松动脱位与感染等并发症。结论人工半肩关节置换是治疗老年肱骨近端复杂骨折的一种有效方法。术中必须注意修复受损的肩袖与正确重建大小结节，同时术后早期进行关节功能锻炼，可取得满意的临床效果。
목적：탐토반견관절치환치료노년굉골근단복잡골절적방법급림상료효。방법대15례행인공반견관절치환술적노년굉골근단골절환자진행회고분석，평균년령67.0세，안Neer분형：삼부분골절2례，사부분골절13례。근거Neer평분계통대반견관절치환술후견관절진행공능평고。결과소유환자균획수방，수방시간9～36개월，평균25개월。안Neer평분：우4례，량9례，가2례，우량솔80％，견관절활동범위평균위：전굴상거95°，후신30°，외전80°，내수20°，외선20°，내선30°。전부환자무가체송동탈위여감염등병발증。결론인공반견관절치환시치료노년굉골근단복잡골절적일충유효방법。술중필수주의수복수손적견수여정학중건대소결절，동시술후조기진행관절공능단련，가취득만의적림상효과。
Objective To investigate the methods and the clinical outcomes of the semi-shoulder arthroplasty in the treatment of complex fractures of the proximal humerus in the elderly.Methods Fifteen cases of complicated proximal humeral fractures who had received hemiarthroplasty with shoulder prosthesis were retrospectively analyzed.The mean age was 67 years.According to Neer classification, two cases were three-part fractures and 13 cases were four-part fractures.The function of the shoulder was evaluated postoperatively by the Neer scores system.Results The patients were followed up for an average time of 25 months (9 to 36 months).According to Neer scoring, four cases were excellent, nine cases were good, and two cases were fair.The excellent rate was 80%.The range of motion ( ROM) of the shoulder was as follows:anteflexion and upthrow was 95°, rear extension was 30°, abduction was 80°, adduction was 20, extorsion was 20°and intorsion was 30°.There was no complication such as prosthesis loosening and dislocation.Conclusions The hemiarthroplasty with shoulder prosthesis is an effective way to treat the elderly patients with complicated proximal humeral fractures. The shoulder cuff should be repaired appropriately, the large and small tuberosities should be correctly reconstructed during the operation;early postoperative exercise should also be applied.