Debeer Philippe, Plasschaert Herbert, Stuyck Jos
Department of Orthopaedics, University Hospital Pellenberg, Weligerveld 1, B-3212 Pellenberg, Belgium.
Acta Orthop Belg. 2006 Apr;72(2):126-30.
Infection of the shoulder joint is a challenging problem for the orthopaedic surgeon. Several treatment options have been proposed. Here, we evaluate the results achieved following resection arthroplasty of the shoulder in seven patients. We performed resection arthroplasty in seven cases to treat a chronic uncontrollable infection of the shoulder. Three patients had an infected shoulder arthroplasty, one had an infected non-united arthrodesis, one was treated for an infected osteosynthesis, one had an infected rotator cuff repair and one patient had a septic arthritis of the shoulder joint. All patients were reviewed after a mean of 252 days. The functional outcome was evaluated using the Constant and DASH score. C-Reactive Protein levels were determined to evaluate the presence of residual infection. Except for one doubtful result, all our patients remained free of infection and there was excellent pain relief after the resection. Nevertheless, the functional outcome was poor: the mean Constant score was 25.7 and the mean DASH score was 69.3. Resection arthroplasty of the shoulder is a valuable treatment option for infection of the shoulder, especially in older patients with a poor mental and physical condition who suffer intolerable pain.
肩关节感染对于骨科医生来说是一个具有挑战性的问题。已经提出了几种治疗选择。在此，我们评估了7例患者行肩关节切除成形术后的结果。我们对7例患者进行了切除成形术，以治疗慢性难治性肩关节感染。3例患者为感染性肩关节置换术后，1例为感染性不愈合关节融合术后，1例因感染性骨固定术接受治疗，1例为感染性肩袖修复术后，1例为肩关节化脓性关节炎。所有患者平均在252天后接受复查。使用Constant和DASH评分评估功能结果。测定C反应蛋白水平以评估是否存在残余感染。除1例结果存疑外，所有患者均无感染，切除术后疼痛缓解良好。然而，功能结果较差：Constant评分平均为25.7，DASH评分平均为69.3。肩关节切除成形术是治疗肩关节感染的一种有价值的治疗选择，尤其适用于精神和身体状况较差、疼痛难忍的老年患者。
