Marchetti M E, Houde J P, Steinberg G G, Crane G K, Goss T P, Baran D T
Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical Center, Worcester 01655, USA.
J Shoulder Elbow Surg. 1996 Nov-Dec;5(6):471-6. doi: 10.1016/s1058-2746(96)80020-6.
This study evaluates disuse osteoporosis of the proximal humerus after shoulder surgery and immobilization. This was accomplished by quantifying bone mineral density changes in 22 patients' proximal humeri after 6 weeks of immobilization for soft-tissue shoulder surgery. The bone mineral density of the humeral head, neck, and proximal diaphyseal subregions was determined 1 to 2 weeks before surgery and at 3, 6, and 12 weeks after surgery with dual-energy x-ray absorptiometry. By the sixth postoperative week statistically significant bone mineral density decreases of 6% to 14% were observed in the humeral neck and head subregions, respectively. The changes in these three regions diminished slightly after 6 weeks of remobilization, but the differences were still statistically significant. No significant bone mineral density changes occurred in any subregion or during any time interval in the nonoperated humerus. Our study represents the first report with dual-energy x-ray absorptiometry to quantify bone loss of the proximal humerus of patients after shoulder immobilization. Further long-term study is warranted to determine the clinical significance of this bone loss and to determine whether these losses are partially or fully recoverable.
本研究评估肩部手术及固定后肱骨近端的废用性骨质疏松。通过对22例因肩部软组织手术而固定6周后的患者肱骨近端骨密度变化进行量化来完成此项研究。在手术前1至2周以及术后3周、6周和12周，采用双能X线吸收法测定肱骨头、颈部和近端骨干区域的骨密度。术后第6周时，在肱骨颈部和头部区域分别观察到骨密度有统计学意义的显著下降，降幅分别为6%至14%。在重新活动6周后，这三个区域的变化略有减小，但差异仍具有统计学意义。未手术侧肱骨的任何区域或任何时间段均未发生显著的骨密度变化。我们的研究是首篇采用双能X线吸收法量化肩部固定后患者肱骨近端骨质流失的报告。有必要进行进一步的长期研究，以确定这种骨质流失的临床意义，以及确定这些骨质流失是否部分或完全可恢复。
