摘要
目的研究人工肩关节置换术中肩袖功能的保护和重建的方法与意义。方法本组15例，男4例，女11例；年龄为36～75岁，平均（57．3±4．8）岁。肱骨近端粉碎性骨折5例，行单极人工肩关节置换术3例，双极人工肩关节1例，全肩关节1例。肱骨近端骨巨细胞瘤5例，骨肉瘤4例，转移癌1例。9例行定制假体置换，1例行双极人工关节。结果术后随访2个月～9年，平均4．6年。肩袖完好、得到保护或修复者均优于肩袖损伤而未得到良好修复者。结论关节置换术的效果取决于患者的病损状况、手术方式和术后功能锻炼，尤其是对肩关节周围软组织的保存和修复，以及肱骨大结节的处理。术中更坚强的肩袖固定和术后更积极的功能康复训练有助于功能的改善。
Objective To explore the significance and the reliable methods of protection and reconstruction of the function of the rotator cuff of the shoulder joint after the joint replacement. Methods Fifteen patients were selected, 4 males and 11 females of 36-75 years old （average 57.3±4.8 years）. Five patients had severe proximal humeral fracture and the hemiarthroplasty was performed in three patients, bipolar in 1 patient, and total joint replacement in 1 patient. Ten patients had proximal humeral tumor, and among them, five had osteo- giant- cytoma, 4 osteosarcoma, 1 metastasis cancer. In these ten patients, 9 received custom- made prosthesis, while one patient received bipolar prosthesis. Results The postoperative follow - up ranged from 2 months to 9 years, 4.6 years on average. The results of the fracture patients were better than those of the tumor patients according to the pain relief and recovery of joint movement and the roentgen and the opinions of the patients. Conclusion The rotator cuff is of great importance to the joint. The result of the surgery depends on the design of the prosthesis and the operation methods and the postoperative rehabilitation, especially on the protection and reconstruction of the integrity and validity of the rotator cuff and muscles around the shoulder joint, and the management of the great tubercle. The stronger fixation of the cuff and the more energetic rehabilitation bring the more improvement of the joint function.
出处
《中国骨与关节损伤杂志》
2007年第4期277-279,共3页
Chinese Journal of Bone and Joint Injury
关键词
肩关节
人工关节置换术
肩袖
骨折
Shoulder joint
Arthroplasty
Rotator cuff
Fracture
