EFFECTIVENESS ANALYSIS OF ARTIFICIAL HUMERAL HEAD REPLACEMENT FOR 18 CASES OFCOMPLICATED FRACTURES OF THE PROXIMAL HUMERUS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WAN Yongxian ¹ , XU Lili ² , LU Xiaobo ¹ , ZHANG Zhongjie ¹ , GE Jianhua ¹ , CHEN Ge ¹ , TAN Meiyun. ¹

1Department of Orthopedics, 2Department of Rehabilitation, Affiliated Hospital of LuzhouMedical College, Luzhou Sichuan, 646000, P.R.China.;

Corresponding author：

Keywords：

Complicated proximal humerus fracture; Artificial humeral head replacement; Effectiveness analysis

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【Abstract】 Objective To evaluate the effectiveness of artifical humeral head replacement in treatment of complicated
fractures of the proximal humerus. Method Between January 2005 and January 2011, 18 patients with proximal humerus
fracture were treated with artifical humeral head replacement. There were 8 males and 10 females with a mean age of 71 years (range, 52-84 years). Fractures were caused by falling in 11 cases, by traffic accident in 3 cases, and by bruise in 4 cases. The time between injury and admission was 2 hours to 3 days (mean, 1.5 days). According to Neer classification, 8 cases had three-part fracture, 7 four-part fracture, and 3 cleavage fracture of humeral head; 5 cases complicated by shoulder joint subluxation, 2 cases by femoral fracture, 1 case by radial fracture, and 11 cases by osteoporosis. All the patients were treated with modular cemented prostheses. Results The operation time was 60-180 minutes with an average of 80 minutes; the blood loss was 100-400 mL with an average of 200 mL. All incisions healed by first intention without infection or neurovascular injury. Sixteen patients were followed up 3 years on average (range, 1-6 years). No loosening, dislocation of prothesis or heterotopic ossification occurred. According to the Neer scores, the results were excellent in 5 cases, good in 8 cases, moderate in 2 cases, and poor in 1 case at 1 year after operation. The excellent and good rate was 81.2%. Conclusion Artificial humeral head replacement is a good therapy for patients with complicated fractures of the proximal humerus, especially for elderly patients.

Citation： WAN Yongxian,XU Lili,LU Xiaobo,ZHANG Zhongjie,GE Jianhua,CHEN Ge,TAN Meiyun.. EFFECTIVENESS ANALYSIS OF ARTIFICIAL HUMERAL HEAD REPLACEMENT FOR 18 CASES OFCOMPLICATED FRACTURES OF THE PROXIMAL HUMERUS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(2): 205-207. doi: Copy

1.	McKoy BE, Bensen CV, Hart sock LA. Fractures about the shoulder: conservative management. Orthop Clin North Am, 2000, 31(2): 205-216.
2.	Strohm PC, Köstler W, Südkamp NP. Proximal humerus fracture—what to do? Z Orthop Unfall, 2008, 146 (3): 312-317.
3.	Neer CS 2nd. Displaced proximal humeral fractures. I. Classification and evalution. J Bone Joint Surg (Am), 1970, 52(6): 1077-1089.
4.	Neer CS 2nd, Watson KC, Stanton FJ. Recent experience in total shoulder replacement. J Bone Joint Surg (Am), 1982, 64(3): 319-337.
5.	刘阳, 李正维. 肱骨近端骨折的手术治疗现状. 骨与关节损伤杂志, 2004, 19(2): 135-137.
6.	Visser CP, Coene LN, Brand R, et al. Nerve lesions in proximal humeral fractures. J Shoulder Elbow Surg, 2001, 10(5): 421-427.
7.	Gibson JN, Handoll HH, Madhok R. Interventions for treating proximal humeral fractures in adults. Cochrane Data base Syst Rev, 2002, (2): CD000434.
8.	Heers G, Torchia ME. Shoulder hemi-arthroplasty in proximal humeral fractures. Orthopade, 2001, 30(6): 386-394.
9.	马广文, 李军, 吕欧, 等. 肱骨近端四部分骨折治疗方式的探讨. 临床骨科杂志, 2006, 9(6): 539-541.
10.	Phinpatanakul WP, Norris TR. Indications for prosthetic replacement in proximal humeral fractures. Instr Course Lect, 2005, 54: 357-362.
11.	Gierer P, Simon C, Gradl G, et al. Complex proximal humerus fractures—management with a humeral head prosthesis? Clincal and radiological results of a prospective study. Orthopade, 2006, 35(8): 834-840.
12.	Ahir SP, Walker PS, Squire-Taylor CJ, et al. Analysis of glenoid fixation for a reversed anatomy fixed-fulcrum shoulder replacement. J Biomech, 2004, 37(11): 1699-1708.
13.	臧危平, 马涛, 王伟, 等. 半肩关节置换术治疗肱骨近端复杂骨折疗效分析. 中国矫形外科杂志, 2011, 19(4): 280-283.
14.	Esen E, Doğramaci Y, Gultekin S, et al. Factors affecting results of patients with humeral proximal and fractures undergoing primary hemiarthroplasty: a retrospective study in 42 patients. Injury, 2009, 40(12): 1336-1341.
15.	顾志坚, 王永刚, 王哲军, 等. 人工肱骨头置换治疗老年肱骨近端三、四部分骨折. 中国骨与关节损伤杂志, 2006, 21(3): 205-206.
16.	廖春来, 王培信, 谢逸波, 等. 老年骨质疏松性肱骨近端粉碎性骨折手术方式的选择. 中国修复重建外科杂志, 2009, 23(12): 1443-1446.
17.	王娟, 黄富国. 喙肩韧带对肩关节前上方稳定作用的生物力学研究. 中国修复重建外科杂志, 2009, 23(1): 49-51.
18.	Kralinger F, Schwaiger R, Farrell E, et al. Outcome after primary hemiarthroplasty for fracture of the head of the humerus. A retrospective multicentre study of 167 patients. J Bone Joint Surg (Br), 2004, 86(2): 217-219.

1. McKoy BE, Bensen CV, Hart sock LA. Fractures about the shoulder: conservative management. Orthop Clin North Am, 2000, 31(2): 205-216.
2. Strohm PC, Köstler W, Südkamp NP. Proximal humerus fracture—what to do? Z Orthop Unfall, 2008, 146 (3): 312-317.
3. Neer CS 2nd. Displaced proximal humeral fractures. I. Classification and evalution. J Bone Joint Surg (Am), 1970, 52(6): 1077-1089.
4. Neer CS 2nd, Watson KC, Stanton FJ. Recent experience in total shoulder replacement. J Bone Joint Surg (Am), 1982, 64(3): 319-337.
5. 刘阳, 李正维. 肱骨近端骨折的手术治疗现状. 骨与关节损伤杂志, 2004, 19(2): 135-137.
6. Visser CP, Coene LN, Brand R, et al. Nerve lesions in proximal humeral fractures. J Shoulder Elbow Surg, 2001, 10(5): 421-427.
7. Gibson JN, Handoll HH, Madhok R. Interventions for treating proximal humeral fractures in adults. Cochrane Data base Syst Rev, 2002, (2): CD000434.
8. Heers G, Torchia ME. Shoulder hemi-arthroplasty in proximal humeral fractures. Orthopade, 2001, 30(6): 386-394.
9. 马广文, 李军, 吕欧, 等. 肱骨近端四部分骨折治疗方式的探讨. 临床骨科杂志, 2006, 9(6): 539-541.
10. Phinpatanakul WP, Norris TR. Indications for prosthetic replacement in proximal humeral fractures. Instr Course Lect, 2005, 54: 357-362.
11. Gierer P, Simon C, Gradl G, et al. Complex proximal humerus fractures—management with a humeral head prosthesis? Clincal and radiological results of a prospective study. Orthopade, 2006, 35(8): 834-840.
12. Ahir SP, Walker PS, Squire-Taylor CJ, et al. Analysis of glenoid fixation for a reversed anatomy fixed-fulcrum shoulder replacement. J Biomech, 2004, 37(11): 1699-1708.
13. 臧危平, 马涛, 王伟, 等. 半肩关节置换术治疗肱骨近端复杂骨折疗效分析. 中国矫形外科杂志, 2011, 19(4): 280-283.
14. Esen E, Doğramaci Y, Gultekin S, et al. Factors affecting results of patients with humeral proximal and fractures undergoing primary hemiarthroplasty: a retrospective study in 42 patients. Injury, 2009, 40(12): 1336-1341.
15. 顾志坚, 王永刚, 王哲军, 等. 人工肱骨头置换治疗老年肱骨近端三、四部分骨折. 中国骨与关节损伤杂志, 2006, 21(3): 205-206.
16. 廖春来, 王培信, 谢逸波, 等. 老年骨质疏松性肱骨近端粉碎性骨折手术方式的选择. 中国修复重建外科杂志, 2009, 23(12): 1443-1446.
17. 王娟, 黄富国. 喙肩韧带对肩关节前上方稳定作用的生物力学研究. 中国修复重建外科杂志, 2009, 23(1): 49-51.
18. Kralinger F, Schwaiger R, Farrell E, et al. Outcome after primary hemiarthroplasty for fracture of the head of the humerus. A retrospective multicentre study of 167 patients. J Bone Joint Surg (Br), 2004, 86(2): 217-219.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS ANALYSIS OF ARTIFICIAL HUMERAL HEAD REPLACEMENT FOR 18 CASES OFCOMPLICATED FRACTURES OF THE PROXIMAL HUMERUS

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