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反式全肩关节置换术治疗肱骨近端骨折失败。

Reverse total shoulder arthroplasty for failed treatment of proximal humerus fractures.

机构信息

Department of Orthopedics and Traumatology, Acıbadem Maslak Hospital, İstanbul, Turkey;Department of Orthopedics and Traumatology, Acıbadem Mehmet Ali Aydınlar University, School of Medicine, İstanbul, Turkey.

Department of Orthopedics and Traumatology, Acıbadem Maslak Hospital, İstanbul, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2021 Dec;55(6):480-485. doi: 10.5152/j.aott.2021.20387.

Abstract

OBJECTIVE

The aim of this study was to evaluate the functional and radiological outcomes and complications of reverse total shoulder arthroplasty (RTSA) for failed treatment of proximal humerus fractures (FTPHF).

METHODS

In this retrospective study, 20 patients (17 female, 3 male; mean age = 71.35 years; age range = 54-81 years) who underwent RTSA for FTPHF between 2012 and 2018 were included. The mean follow-up was 37.85 (range: 24-83) months. Outcome measures included shoulder range of motion, Constant score, ASES (American Shoulder and Elbow Surgeons) score, visual analog scale (VAS). Intra-or post-operative complications were also recorded.

RESULTS

The mean anterior flexion and external rotation improved from 37.25°±10.59° and 11.05°±4.79° preoperatively to 105.53° ± 9.33 and 22.37° ± 4.12° postoperatively, respectively (P < 0.01 for both). The mean Constant and ASES scores ameliorated from 21.95 ± 3.57 and 18.15 ± 4.69 preoperatively to 61.7 ± 7.6 and 71.18 ± 4.69 at the final follow-up, respectively (P < 0.01 for both). VAS significantly reduced from 6.83 ± 2.04 preoperatively to 1.79 ± 0.61 at the final follow-up (P < 0.01). None of the patients had major complications or required revision.

CONCLUSION

Treatment with the RTSA for the FTPHF seems to be an effective treatment method that can provide satisfactory radiological and functional outcomes with low complication rates.

LEVEL OF EVIDENCE

Level IV, Therapeutic Study.

摘要

目的

本研究旨在评估反式全肩关节置换术(RTSA)治疗肱骨头骨折失败(FTPHF)的功能和影像学结果及并发症。

方法

在这项回顾性研究中,纳入了 2012 年至 2018 年间因 FTPHF 接受 RTSA 治疗的 20 名患者(17 名女性,3 名男性;平均年龄=71.35 岁;年龄范围 54-81 岁)。平均随访时间为 37.85(24-83)个月。评估指标包括肩关节活动范围、Constant 评分、ASES(美国肩肘外科医师协会)评分、视觉模拟评分(VAS)。还记录了术中或术后并发症。

结果

术前,肩关节前屈和外旋分别为 37.25°±10.59°和 11.05°±4.79°,术后分别改善至 105.53°±9.33°和 22.37°±4.12°(均 P<0.01)。术前 Constant 和 ASES 评分分别为 21.95±3.57 和 18.15±4.69,术后分别改善至 61.7±7.6 和 71.18±4.69(均 P<0.01)。VAS 评分由术前的 6.83±2.04 显著降低至末次随访时的 1.79±0.61(P<0.01)。所有患者均无严重并发症或需要翻修。

结论

对于 FTPHF,RTSA 治疗似乎是一种有效的治疗方法,可获得令人满意的影像学和功能结果,且并发症发生率低。

证据等级

IV 级,治疗性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcec/11583225/b4a98ce5d148/AOTT-D-20-00387-g01.jpg

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