陳旧性上腕骨近位端2-, 3-part 骨折に対する人工骨頭置換術例の術後成績 : 新鮮例との比較

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We wish to evaluate the results of hemiarthroplasty for chronic 2- and 3- part fractures of the proximal humerus. Thirty-five cases of humeral hemiarthroplasty using Neer II prosthesis were performed for 2- and 3- part fractures of proximal humerus from 1986 to 1999. Twenty-one cases (chronic-group : 7, acute-group : 14) were evaluated by the Neer scoring system. At the time of injury, patients average age was 63 y/o in chronic-group, and 59.6 y/o in acute-group. The average time elapsed from injury to surgery was 10.4 months in chronic-group, and 13.7 days in acute-group. The average follow-up period was 26.7 months in chronic-group, and 51.6 months in acute-group. The chronic-group consisted of three nonunions of 2- part surgical neck fracture and four cases following 3- part fractures (one nonunion, two malunions, one humeral head necrosis). The acute-group consisted of one 2- part anatomical neck fracture, one fracture-dislocation, nine 3- part fractures and three 3- part fracture-dislocations. In chronic-group, preoperative / postoperative Neer scores were 43.6 / 58.7 (pain : 24.3 / 30.7, function : 11.4 / 14.0, ROM : 6.4 / 8.7, and anatomy : 1.4 / 5.3). In acute-group, the postoperative Neer scores were 80.6 (pain : 32.1, function : 24.7, ROM : 15.0, and anatomy : 8.8). In acute-group, 3 patients had an excellent result, 6 patients had a satisfactory result, 4 patients had an unsatisfactory result and 1 patient had a failure result. All patients in chronic-group had a failure result. The results of chronic-group were worse than those of acute-group. However, in chronic-group, pain and external rotation were improved, compared to results of acute-group. The results of hemiarthroplasty for chronic fractures showed a significant improvement for pain, external rotation and ADL, however, these were inferior to those for acute fractures.
日本肩関節学会の論文
2002-01-01

陳旧性上腕骨近位端2-, 3-part 骨折に対する人工骨頭置換術例の術後成績 : 新鮮例との比較

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