Cofield R H, Briggs B T
J Bone Joint Surg Am. 1979 Jul;61(5):668-77.
Seventy-one shoulders of seventy patients were fused for treatment of various conditions, and the results were analyzed after an average follow up of nine years and six months. The operative technique always included the use of internal fixation. The average position of arthrodesis was 45 degrees of abduction and 25 degrees of flexion of the arm, with the flexed forearm rotated 21 degrees above the horizontal plane, measured with the arm abducted and flexed. In sixty-eight shoulders, one operation achieved a solid fusion; in the other three, a second arthrodesis was required. Complications included tenderness over the outer ends of the internal fixation device, which required its removal from seventeen shoulders; a fracture in the fused extremity in ten patients; and a post-operative infection in one. Relief of pain was adequate in three-quarters of the patients. Three-quarters of the patients could perform activities involving reaching the trunk, one-half could do activities requiring reaching the head, and one-quarter were able to do light work with the arm at shoulder level or higher. The position of fusion had little effect on the result. Eighty-two per cent of the entire group believed that they had benefited from the operation, and none of the results deteriorated with time.
为治疗各种病症，对70例患者的71个肩部进行了融合手术，并在平均随访9年零6个月后对结果进行了分析。手术技术始终包括使用内固定。关节融合的平均位置为手臂外展45度、屈曲25度，在前臂屈曲且手臂外展的状态下测量，屈曲的前臂在水平面上方旋转21度。在68个肩部中，一次手术即实现了牢固融合；在另外3个肩部中，则需要进行二次关节融合术。并发症包括内固定装置外端压痛，17个肩部需要取出内固定装置；10例患者融合肢体出现骨折；1例发生术后感染。四分之三的患者疼痛得到充分缓解。四分之三的患者能够进行触及躯干的活动，一半患者能够进行触及头部的活动，四分之一的患者能够在肩部水平或更高位置用手臂进行轻度工作。融合位置对结果影响不大。整个组中有82%的人认为手术使他们受益，且结果均未随时间恶化。
