半肩置换治疗肱骨近端骨折的临床进展△

Clinical progress in shoulder hemiarthroplasty in the treatment of proximal humeral fractures

摘要:

近年来，随着人口老龄化的加剧，肱骨近端骨折 （proximal humeral fractures, PHFs） 的发病率逐年上升。由于其不良预后，严重影响患者的生活质量，并造成显著的社会负担。目前，半肩置换术（shoulder hemiarthroplasty, SHA）是治疗 PHFs 的传统手术方法，但其术后功能恢复存在较大不确定性。此外，反肩置换术（reverse shoulder arthroplasty, RSA）技术的发展使得 SHA 的适用性受到质疑，其在全球的使用比例也呈下降趋势。尽管如此，SHA 在 PHFs 治疗中仍具有重要的应用价值。为探讨 SHA 在 PHFs 治疗中的实际意义，本研究通过文献综述分析 SHA 的疗效、应用现状、失败风险因素及手术技术，以期为临床医师制定治疗方案提供参考依据。

Abstract:

In recent years, with the aging of the population, the incidence of proximal humeral fractures (PHFs) increased year by year. Due to their poor prognosis, such fractures seriously impact the quality of life of patients and cause significant social burden. At present, shoulder hemiarthroplasty (SHA) is the traditional surgical method for the treatment of PHFs, although its postoperative functional recovery remains uncertainty in some extent. On other hand, the development of reverse shoulder arthroplasty (RSA) made the applicability of SHA questioned with the proportion of using SHA decreased worldwide. Nevertheless, the SHA still has important value in the treatment of PHFs. In order to explore the practical significance of SHA in the treatment of PHFs, this article analyzes the efficacy, application status, risk factors for failure and surgical techniques of SHA through a literature review to provide a reference for clinicians in formulating treatment plans.