Des Marchais J E, Benazet J P
Can J Surg. 1983 Sep;26(5):469-71.
Eighteen patients with fractures of the proximal humerus with at least four fragments, with or without dislocation (group IV, V and VI of Neer's classification), were treated by hemiprosthetic replacement. The average age was 59 years. The follow-up was from 1 to 7 years. Patients were assessed on two occasions by two evaluators using Neer's protocol. The glenohumeral and the scapulothoracic movements, using the other shoulder as control, were measured radiologically at 0 degrees, 45 degrees and maximal abduction. Pain, function and range of motion were recorded. No complication was encountered. By radiologic assessment, it was possible to classify results in three groups. In all of the unsatisfactory results, the centre of motion of the prosthesis was displaced proximally. Satisfactory and excellent results were obtained in 66%. The best results are obtained if patients are operated on early; repair of the rotator cuff is important. The centre of rotation of the prosthesis must be in precise biomechanical relation to the glenoid fossa; such a relation is of prognostic value.
18例肱骨近端骨折且至少有四块骨折碎片、伴或不伴脱位（Neer分类中的IV、V和VI组）的患者接受了半关节置换治疗。平均年龄为59岁。随访时间为1至7年。由两名评估者根据Neer方案对患者进行两次评估。以对侧肩部为对照，通过放射学测量在0度、45度和最大外展时的盂肱关节和肩胛胸壁运动。记录疼痛、功能和活动范围。未出现并发症。通过放射学评估，可将结果分为三组。在所有不满意的结果中，假体的运动中心向近端移位。66%的患者获得了满意和优异的结果。如果患者早期接受手术，可获得最佳结果；修复肩袖很重要。假体的旋转中心必须与关节盂窝保持精确的生物力学关系；这种关系具有预后价值。
