Boyd A D, Thornhill T S, Barnes C L
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
J Bone Joint Surg Am. 1992 Dec;74(10):1498-504.
In a review of records and radiographs from 1974 through 1988, we identified seven patients who had a humeral fracture after either a total shoulder replacement or a shoulder hemiarthroplasty. All seven patients had complications after the fracture, and five fractures did not unite until an operation was done. All of the fractures that were treated operatively healed without sequelae. Four patients who were managed operatively had satisfactory relief of pain and one had fair relief. One patient who had a non-union refused further treatment for medical reasons. The one fracture that united without operative treatment healed with the tip of the prosthesis outside of the humeral shaft, but persistent pain led to a revision total shoulder replacement. The average time to union after the operation was approximately five months (range, four to seven months). There was a permanent decrease in the motion of the shoulder from preinjury levels in five of the six patients who had union of the fracture.
在回顾1974年至1988年的病历和X光片时，我们确定了7例在全肩关节置换术或半肩关节置换术后发生肱骨骨折的患者。所有7例患者骨折后均出现并发症，5例骨折在手术治疗后才愈合。所有接受手术治疗的骨折均愈合且无后遗症。4例接受手术治疗的患者疼痛得到满意缓解，1例疼痛得到部分缓解。1例骨折不愈合的患者因医疗原因拒绝进一步治疗。1例未经手术治疗而愈合的骨折，假体尖端位于肱骨干外侧，但持续疼痛导致进行了全肩关节置换翻修手术。手术后平均愈合时间约为5个月（范围为4至7个月）。在6例骨折愈合的患者中，有5例肩关节活动度较受伤前出现了永久性下降。
