Olsson E, Andersson D, Broström L A, Wallensten R, Nilsonne U
Department of Orthopedics, Karolinska Hospital, Stockholm, Sweden.
Ann Chir Gynaecol. 1990;79(3):157-60.
Between 1973 and 1985 eighteen patients with bone tumours and two patients with comminuted fractures had their proximal humerus replaced with a custom made isoelastic hemiendoprosthesis. In 1987 a clinical and radiographical review was performed of eleven patients with a mean follow up time of seven years, range 3-10 years. Four patients had pain at rest and six patients experienced severe pain on exertion. Active range of motion was poor and constituted only half of the corresponding range of passive motion. Shoulder girdle muscles were generally weak, only one patient could keep the arm straight in a flexed or abducted position. All patients had returned to their previous occupations, but their ability to perform ADL functions was poor. Rotator cuff insufficiency was considered to be the major cause of poor shoulder function. In comparison to most other surgical alternatives in tumour cases endoprosthetic replacement of the proximal humerus appears to be a safe and reliable method. The endoprosthesis gives stability to the arm and normal elbow and hand function is preserved.
1973年至1985年间，18例骨肿瘤患者和2例粉碎性骨折患者接受了定制的等弹性半关节置换假体置换肱骨近端手术。1987年，对11例患者进行了临床和影像学检查，平均随访时间为7年，范围为3至10年。4例患者静息时疼痛，6例患者用力时疼痛剧烈。主动活动范围较差，仅为相应被动活动范围的一半。肩胛带肌肉普遍较弱，只有1例患者能够在屈曲或外展位置保持手臂伸直。所有患者均已恢复之前的工作，但他们进行日常生活活动（ADL）功能的能力较差。肩袖功能不全被认为是肩部功能不佳的主要原因。与肿瘤病例中的大多数其他手术选择相比，肱骨近端的人工关节置换似乎是一种安全可靠的方法。该假体可使手臂保持稳定，并保留正常的肘部和手部功能。
