摘要
目的:探讨新型自锁铰链型人工全肘关节置换假体在肿瘤、严重肘关节骨关节炎病人及肘关节毁损伤中的初步应用疗效,为此关节应用在临床的广泛开展提供可靠依据。方法:15例因肿瘤、严重骨关节炎破坏、肘关节毁损伤等肘关节疾病患者行肘关节切除,将自行设计的自锁铰链型肘关节假体用骨水泥固定于肱骨和尺骨上,并用横行锁钉将肱骨假体、骨水泥、肱骨固锁成一体。术后1周行被动无痛肘关节功能锻炼。2周被动锻炼结合主动功能锻炼,3周可持物功能锻炼。3个月恢复正常活动,但避免提过重物。结果:术后15例患者随访平均66个月(65～122个月),不同程度恢复了肘关节的正常活动,Mayo肘关节功能评分平均从40(25～70)恢复到95(65～100),与术前比较有显著性差异(P<0.01)。肘关节活动范围从85°(0～120°)到术后的105°(95～125°),与术前比较有显著性差异(P<0.05)。X线片显示无假体松动,部分患者假体与骨移行处有骨形成。术后无神经刺激、麻痹症状,取得满意的临床疗效。结论:自锁人工全肘关节假体设计符合人体生物力学结构,抗旋转和剪切能力强,手术简单可靠,适于肘关节肿瘤、毁损伤的患者应用。
Objective:To study curative effect of self-locked elbow prosthesis on elbow tumor,severe osteoarthritis and smashed elbow wound.Method: Fifteen elbows infected with tumor,severe osteoarthritis and smashed elbow wound within 1995~2004 received total arthroplasty.Self-locked elbow prosthesis were installed into humerus and ulna by fixing with cement,and humeral prosthesis were fixed together with interlock screw.No-pain exercises were started under physicians direction within 1,2,3 weeks and normal activities were resumed in the 3 rd month.Result: The 15 elbows received a follow-up for a mean of 66 months ( range 65~122 months).All patients were satisfied and no pain was found in 15 elbows.There was on radiological sign of loosening in the implanted prosthesis.The Mayo Elbow Performance Score(MEPS) improved from an average of 40 (range 25~70) to an average of 95 (range 65~100) (P<0.01).The arc of flexion improved from an average of 85 degrees (range 0~120 degrees) to 105 degrees (range 95~125 degrees) (P<0.05).Bone formation was observed in prosthesis on humerus side.Conclusion: The design of self-locked elbow prosthesis is suitable to elbow replacement biomechanically and it has strong resistance to rotation and shearing force.It can be used in clinical treatment satisfyingly.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2005年第9期648-650,共3页
Orthopedic Journal of China
关键词
肘关节置换
假体
交锁钉
Elbow replacement
Prosthetics
Self-interlock
