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1、人工肱骨头置换治疗复杂肱骨近端骨折临床疗效分析【摘要】H的探讨人工肱骨头置换治疗复朵肱骨近端骨折的近期临床疗效。方法对16例复杂肱骨近端佇折行半肩关节置换术，术后按美国肩肘关节医师学会(ASES)肩关节评分系统进行疗效评价，包括术后疼痛、主动活动范围和日常行动功能。结果所有患者术后均获得随访,随访时间为6月~48月,平均30.1月。患肩ASES评分平均85.6分(64〜94分)，VAS疼痛评分平均2.7分(0~5分)，肩关节活动度平均为:前曲上举130.1°(90°〜150°),外旋35.0°(30°~4
2、0。)，内旋T10水平。术后1年12例肩关节周围各肌力基本恢复正帘，H常生活能力恢复较为满意，3例肩袖肌力不足，外展、上举稍差，无一例出现假体松动、下沉及脱位。结论人工肱骨头置换术治疗复杂肱骨近端骨折近期疗效满意，但应严格掌握适应证。详细的术前评估重建肱骨正常长度、确切固定大小结节可靠有效地重建启袖重视术后iE规康复训练是捉高疗效的关键。【关键词】肱骨骨折；近端；人工肱骨头置换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胧骨近端骨折是成人I:肢骨折中常见的类型z-,其屮大部分为无移位或移位不明显的骨折，通过保守治疗即可达到愈合。肱骨近端
