肩肘-已翻译39274中文

1、反式人工肩关节置换治疗老年人肱骨头骨折固定大结节可改善外旋、增加力量和提高生活质量 Sana Kliniken AG I Oskar-Messter-Strae 24 I 85737 Ismaning, Germany I David Merschin, MD, M.Sc.ResidentHospital Rummelsberg, a House of Sana Hospital AGDepartment for Trauma-, Shoulder- and Reconstructive Surgery, Sports Medicine (Prof. Dr. Richard Stangl)XX

2、XVI Sicot World CongressGuangzhou, 18th September 2015- 损伤率高，发生率 1.200/100.000 1-发生率持续增长，到2030年: 可望达到 50% 2-生命期内风险值: 13%, 5% 3背景1. Palvanen M, Kannus P, Niemi S et al. (2006) Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res 442:87-922. Ockert B, Biermann N, Haasters F

3、et al. (2013) Reverse shoulder arthroplasty for primary fracture treatment : Displaced three and four part fractures of the proximal humerus in the elderly patient. Unfallchirurg 116:684-6903. Ismail AA, Pye SR, Cockerill WC et al. (2002) Incidence of limb fracture across Europe: results from the Eu

4、ropean Prospective Osteoporosis Study (EPOS). Osteoporos Int 13:565-571- 最佳治疗 尚不明确 5, 6, 7, 8, 9, 10- 反肩置换是一种治疗选择, 结节再固定是不是必需的? 10- 不明确 : - 反肩置换后的功效 -反肩置换后的生活质量 -制度化的程度背景5. Becker R, Pap G, Machner A et al. (2002) Strength and motion after hemiarthroplasty in displaced four-fragment fracture of the

5、proximal humerus: 27 patients followed for 1-6 years. Acta Orthop Scand 73:44-496. Gallinet D, Clappaz P, Garbuio P et al. (2009) Three or four parts complex proximal humerus fractures: hemiarthroplasty versus reverse prosthesis: a comparative study of 40 cases. Orthop Traumatol Surg Res 95:48-557.

6、Kralinger F, Schwaiger R, Wambacher M et al. (2004) e after primary hemiarthroplasty for fracture of the head of the humerus. A retrospective multicentre study of 167 patients. J Bone Joint Surg Br 86:217-2198. Zyto K (1998) Non-operative treatment of comminuted fractures of the proximal humerus in

7、elderly patients. Injury 29:349-3529. Kontakis GM, Tosounidis TI, Christoforakis Z et al. (2009) Early management of complex proximal humeral fractures using the Aequalis fracture prosthesis: a two- to five-year follow-up report. J Bone Joint Surg Br 91:1335-134010. Anakwenze OA, Zoller S, Ahmad CS

8、et al. (2014) Reverse shoulder arthroplasty for acute proximal humerus fractures: a systematic review. J Shoulder Elbow Surg 23:e73-80- 2011年3月-2013年12月 (回顾性)- 指征： 肱骨头3或4部分骨折- 最少12个月的随访- 单一外科医生- Mathys: Affinis Invers 骨折, Bettlach, 瑞典- 三角肌-胸大肌入路- 参数: Constant评分 EQ-5DTM 认知障碍（MMST） 制度化 并发症材料和方法入组标准排除标准年龄 65 years病理骨折不可重建的3-4部分骨折高能量损伤低暴力损伤- 既往肩关节接受过手术无严重认知障碍相关合并症(如：腋神经损伤、感染)- 随访时间 12 monthpolytrauma严重认知障碍(