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急性骨折中的反肩关节置换术比骨折后遗症翻修手术的效果更好。

Reverse shoulder arthroplasty in acute fractures provides better results than in revision procedures for fracture sequelae.

作者信息

Cicak Nikola, Klobucar Hrvoje, Medancic Nenad

出版信息

Int Orthop. 2015 Feb;39(2):343-8. doi: 10.1007/s00264-014-2649-7. Epub 2014 Dec 31.

Abstract

PURPOSE

The purpose of this study was to evaluate functional outcomes of reverse shoulder arthroplasty (RSA) in patients with acute fracture and sequelae of the proximal humeral fractures.

METHODS

Thirty-seven patients were treated with RSA for acute fracture and sequelae of a proximal humeral fracture. The average age was 73 years (range 50-87 years). Twenty-one patients had had no previous surgery, seven patients had acute fractures and 14 patients had chronic fractures. Sixteen patients had had previous surgery. Active range of motion and Constant score were evaluated at a minimum follow-up of two years.

RESULTS

Active elevation was 102°, external rotation 24°, and internal rotation was up to L4 in all patients. In the group of patients without previous surgery treated with RSA, elevation was 116°, external rotation 24°, and internal rotation up to L3. In the group of patients with previous surgery treated with RSA, elevation was 84°, external rotation 19°, and internal rotation up to L4. In the group of patients with acute fracture treated with RSA, elevation was 124°, external rotation 28°, and internal rotation up to L4. In the group of patients with chronic or sequel of the fractures treated with RSA elevation was 114° , external rotation 28°, and internal rotation up to L3. Constant score in all patients was 54. Constant score in patients without previous surgery treated with RSA was 68 and with previous surgery it was 42.

CONCLUSION

Patients without previous surgery treated with RSA for fractures had better functional results than patients who had undergone previous surgery.

摘要

目的

本研究旨在评估急性肱骨近端骨折及肱骨近端骨折后遗症患者行反肩关节置换术(RSA)后的功能结果。

方法

37例患者因急性肱骨近端骨折及后遗症接受了RSA治疗。平均年龄73岁(范围50 - 87岁)。21例患者既往未接受过手术,7例患者为急性骨折,14例患者为慢性骨折。16例患者既往接受过手术。在至少两年的随访中评估主动活动范围和Constant评分。

结果

所有患者的主动抬高角度为102°,外旋角度为24°,内旋角度可达L4。在未接受过手术且接受RSA治疗的患者组中,抬高角度为116°,外旋角度为24°,内旋角度可达L3。在接受过手术且接受RSA治疗的患者组中,抬高角度为84°,外旋角度为19°,内旋角度可达L4。在因急性骨折接受RSA治疗的患者组中,抬高角度为124°,外旋角度为28°,内旋角度可达L4。在因骨折后遗症接受RSA治疗的慢性骨折患者组中,抬高角度为114°,外旋角度为28°,内旋角度可达L3。所有患者的Constant评分为54分。未接受过手术且接受RSA治疗的患者Constant评分为68分,接受过手术的患者评分为42分。

结论

因骨折接受RSA治疗且未接受过手术的患者比接受过手术的患者功能结果更好。

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