若年者上腕骨近位端骨折に対する人工骨頭置換術の長期治療成績(10年以上)

概要

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The purpose of this study was to evaluate the long term results of humeral head replacement (hemiarthroplasty) of the shoulder in young patients (<30 years of age).In this study, we investigated 5 shoulders of 5 patients (all males) for the hemiarthroplasty (Kirschner modular type II-C and Neer II) of the shoulder. The average age was 23.8 years old(range, 17-30 years old), and the average follow-up was 137.2 months (range, 121-167 months). Fractures were 2-part (anatomical neck fracture) in 2 patients, 3-part (humeral head necrosis after fracture) in 1, and 4-part in 2. Functional evaluation was done by use of the JOA score. The follow-up radiographs were compared with the postoperative radiographs, and all were scrutinized with regard to prosthetic loosening, superior migration and ectopic bone formation.There were no complications in all patients. The average JOA score was 85.2 points (range, 62-100 points). 2 patients (desorption of greater tuberosity and humeral head necrosis) had poor clinical outcomes for limitation of ROM. No cases of prosthetic loosening and superior migration of the prosthesis were found in all patients. Cemented hemiarthroplasty of the shoulder is a viable treatment option for younger, active patients. Implant loosening and osteoarthritis of the glenoid do not appear to be concerns in the long term despite the high activity levels of all patients.
日本肩関節学会の論文
2009-07-27