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肱骨近端复杂骨折的大干骺端容积半关节成形术的疗效

Outcomes for a large metaphyseal volume hemiarthroplasty in complex fractures of the proximal humerus.

作者信息

White Jonathan J E, Soothill John R, Morgan Marie, Clark David I, Espag Marius P, Tambe Amol A

机构信息

Department of Trauma and Orthopaedics, Royal Derby Hospital, Derby, UK.

Department of Trauma and Orthopaedics, Royal Derby Hospital, Derby, UK.

出版信息

J Shoulder Elbow Surg. 2017 Mar;26(3):478-483. doi: 10.1016/j.jse.2016.08.004. Epub 2016 Oct 10.

Abstract

BACKGROUND

A large metaphyseal volume shoulder hemiarthroplasty has been in use within our department since 2008; however, no clinical outcome data are available for this prosthesis apart from the designer surgeon series.

MATERIALS AND METHODS

During a 5-year period, data were collected for 40 patients (30 women, 10 men) treated consecutively with the Zimmer Anatomical Shoulder Fracture hemiarthroplasty system (Zimmer, Warsaw, IN, USA).

RESULTS

The final analysis included 26 patients. The median age was 79 years (range, 58-91 years), and the median follow-up was 3.7 years (range, 2.0-5.8 years). The median Constant Score was 34 points (range, 16-70 points), and the median Oxford Shoulder Score was 27 points (range, 5-46 points). The greater tuberosity healed satisfactorily in 12 patients. Resorption of the greater tuberosity was seen radiologically in 18 patients. The presence of resorption had no significant effect on the Constant Score (P = .264) or the Oxford Shoulder Score (P = .469). Three patients (12%) required revision.

CONCLUSIONS

This is the first report from a nondesigner center for outcomes for this prosthesis to date. The results demonstrate reduced functional performance compared with the designer series.

摘要

背景

自2008年起,我们科室开始使用大干骺端容积的半肩关节置换术;然而,除了设计者所在的外科医生系列外,尚无该假体的临床疗效数据。

材料与方法

在5年期间,收集了连续接受齐默解剖型肩部骨折半关节置换系统(美国印第安纳州华沙市的齐默公司)治疗的40例患者(3名女性,10名男性)的数据。

结果

最终分析纳入26例患者。中位年龄为79岁(范围58 - 91岁),中位随访时间为3.7年(范围2.0 - 5.8年)。Constant评分中位数为34分(范围16 - 70分),牛津肩部评分为27分(范围5 - 46分)。12例患者大结节愈合良好。18例患者在影像学上可见大结节吸收。吸收的存在对Constant评分(P = 0.264)或牛津肩部评分(P = 0.469)无显著影响。3例患者(12%)需要翻修。

结论

这是迄今为止非设计者中心关于该假体疗效的首份报告。结果显示与设计者系列相比功能表现有所降低。

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