Shoulder Service, Beijing Ji Shui Tan Hospital, School of Medicine, Peking University, Beijing, China.
Shoulder Service, Beijing Ji Shui Tan Hospital, School of Medicine, Peking University, Beijing, China.
J Shoulder Elbow Surg. 2014 Oct;23(10):1437-43. doi: 10.1016/j.jse.2014.04.017.
Proper positioning and healing of the greater tuberosity are key for functional shoulder recovery after hemiarthroplasty for complex proximal humeral fractures. The purpose of this study was to compare the outcomes after hemiarthroplasty between a trabecular metal prosthesis and a conventional prosthesis in the treatment of complex proximal humeral fractures.
A prospective, comparative study was performed. We compared a trabecular metal shoulder prosthesis for the treatment of complex proximal humeral fractures in a cohort of 35 consecutive patients (TM group) with a conventional prosthesis in a cohort of 38 consecutive patients (conventional group). All the patients, with a mean age of 63.9 years, were prospectively followed-up for a mean time of 4.6 years (range, 3-6 years) after surgery.
At the last follow-up, radiographic complication rates related to the greater tuberosity were lower in the TM group (6.1%) than in the conventional group (25.7%) (P = .028). The mean functional shoulder scores, as well as mean active forward elevation and external rotation, were better in the TM group than in the conventional group.
Radiographic complication rates related to the greater tuberosity were significantly lower in the TM group than in the conventional group. The functional shoulder scores and active forward elevation and external rotation were all better in the TM group than in the conventional group. These findings could imply better healing potential of the greater tuberosity after hemiarthroplasty with a trabecular metal prosthesis to treat complex proximal humeral fractures.
在复杂的肱骨近端骨折行人工半肩关节置换术后，大结节的正确定位和愈合是肩关节功能恢复的关键。本研究旨在比较在治疗复杂肱骨近端骨折时，使用多孔金属假体和传统假体的人工半肩关节置换术后的结果。
前瞻性比较研究。我们比较了 35 例连续患者（TM 组）使用多孔金属肩假体治疗复杂肱骨近端骨折，与 38 例连续患者（传统组）使用传统假体治疗。所有患者平均年龄 63.9 岁，术后平均随访时间为 4.6 年（范围 3-6 年）。
末次随访时，TM 组（6.1%）与传统组（25.7%）相比，与大结节相关的放射影像学并发症发生率较低（P =.028）。TM 组的平均肩关节功能评分以及主动前屈和外展活动度均优于传统组。
TM 组与传统组相比，与大结节相关的放射影像学并发症发生率显著降低。TM 组的肩关节功能评分以及主动前屈和外展活动度均优于传统组。这些发现可能意味着多孔金属假体治疗复杂肱骨近端骨折的人工半肩关节置换术后，大结节有更好的愈合潜力。
