Cazeneuve J F, Cristofari D-J
Department of Orthopaedic Surgery, Orthopaedic Centre, Centre Hospitalier, 0200-Laon, France.
J Bone Joint Surg Br. 2010 Apr;92(4):535-9. doi: 10.1302/0301-620X.92B4.22450.
We have previously described the short-term outcome of the use of reverse shoulder arthroplasty in the treatment of acute complex proximal humeral fractures in the elderly. We now report the clinical and radiological outcome of 36 fractures at a mean of 6.6 years (1 to 16). Previously, at a mean follow-up of 6 years (1 to 12) the mean Constant score was 58.5; this was reduced to 53 points with the further follow-up. A total of 23 patients (63%) had radiological evidence of loosening of the glenoid component. Nevertheless, only one patient had aseptic loosening of the baseplate at 12 years' follow-up. The reduction in the mean Constant score with longer follow-up and the further development of scapular notching is worrying. New developments in design, bearing surfaces and surgical technique, and further follow-up, will determine whether reverse shoulder arthroplasty has a place in the management of complex proximal humeral fractures in the elderly.
我们之前描述过使用反肩关节置换术治疗老年急性复杂肱骨近端骨折的短期疗效。现在我们报告36例骨折患者平均6.6年（1至16年）的临床和影像学结果。此前，平均随访6年（1至12年）时，Constant评分均值为58.5分；随着进一步随访，该评分降至53分。共有23例患者（63%）有影像学证据显示肩胛盂假体松动。然而，在12年随访时，只有1例患者出现基板无菌性松动。随着随访时间延长，Constant评分均值降低以及肩胛盂切迹进一步发展令人担忧。假体设计、关节面和手术技术的新进展以及进一步随访，将决定反肩关节置换术在老年复杂肱骨近端骨折治疗中是否有一席之地。
