Zyto K, Wallace W A, Frostick S P, Preston B J
Nottingham Shoulder and Elbow Unit, Queens Medical Centre, UK.
J Shoulder Elbow Surg. 1998 Mar-Apr;7(2):85-9. doi: 10.1016/s1058-2746(98)90215-4.
We reviewed 27 patients who had sustained displaced three- or four-part fractures of the proximal humerus and who were treated with a humeral hemiarthroplasty. Seventeen patients had a three-part fracture, and 10 had a four-part fracture. The mean follow-up period was 39 months (12 to 94 months). All fractures were classified according to Neer's classification. The Constant score was used for their follow-up evaluation. The median Constant score at follow-up was 51 for the three-part fractures and 46 for the four-part fractures. The median range of movement for all the patients in flexion was 70 degrees, abduction 70 degrees, internal rotation 50 degrees, and external rotation 45 degrees. Nine patients still had moderate or severe pain. Eight patients had moderate or severe disability. Our results were disappointing, and further studies on open reduction and fixation are therefore justified.
我们回顾了27例肱骨近端移位三部分或四部分骨折并接受肱骨半关节成形术治疗的患者。17例为三部分骨折，10例为四部分骨折。平均随访期为39个月（12至94个月）。所有骨折均根据Neer分类法进行分类。采用Constant评分进行随访评估。三部分骨折患者随访时Constant评分中位数为51分，四部分骨折患者为46分。所有患者屈曲的中位活动范围为70度，外展70度，内旋50度，外旋45度。9例患者仍有中度或重度疼痛。8例患者有中度或重度残疾。我们的结果令人失望，因此有理由对切开复位内固定进行进一步研究。
