高齢者の上腕骨近位端骨折に対する人工骨頭置換術の術後成績
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<B>Background:</B> The incidence of 3- or 4-part fracture of the proximal humerus in elderly people has been increasing according to some recent reports. Thus careful attention should be paid to the treatment of unstable humerus proximal fracture in eldery. In this study, we show our clinical consequences of hemiarthroplasty for the treatment of proximal displaced, unstable humerus fractures.<BR><B>Methods:</B> Eleven patients including 1 male and 10 females (11 shoulders) underwent hemiarthroplasty due to having 3- or 4-part fracture of the proximal humerus. The mean age at the surgery was 74.9 years (66 to 90 years) and the mean follow-up period was 20.9 months (6 to 86 months). We evaluated Japanese Orthopedic Association (JOA) Shoulder Score in addition to the range of motion (ROM) and radiographic findings including acromiohumeral interval (AHI) and displacement of greater tuberosity.<BR><B>Results:</B> The mean active ROM was 90 ± 26° in flexion, 81.8 ± 31.2° in abduction and 24.4 ± 32.2° in external rotation. JOA score at the final clinical checkup was 72.8 ± 11 points (Pain: 24.1 ± 5.8, Function:14.7 ± 3.5, ROM: 18.5 ± 5.5, X-ray: 3.73 ± 1.0, Stability: 11.8 ± 2.5) on average. In radiographic findings, 8 shoulders indicated excessive displacement of greater tuberosity (more than 10mm) and 4 shoulders showed less than 5 mm in AHI.<BR><B>Conclusion:</B> Our study suggested that hemiarthroplasty for a proximal humerus fracture in the elderly resulted in good pain relief, however, it might be less effective in terms of the functional and ROM recovery.
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