肱骨头置换术治疗效果影响因素分析

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摘要目的：探讨影响肱骨头置换治疗效果的相关因素。方法：选择2010年1月至2014年1月在温州医科大学附属第二医院行肱骨头置换术的患者52例，记录年龄、性别、受伤原因、骨折类型、受伤至手术时间、术后开始锻炼时间、是否定期门诊随访、是否伴有骨质疏松等情况，应用美国肩肘外科医师协会（ASES）评分进行肱骨头置换术治疗效果评估；对上述指标进行单因素分析，再将差异有统计学意义的变量用logistic回归模型分析其对肱骨头置换术治疗效果的影响。结果：单因素分析显示：年龄、受伤至手术时间、术后开始锻炼时间、是否定期门诊随访、是否伴骨质疏松是影响肱骨头置换手术疗效的因素（P＜0.05）。多因素logistic回归分析显示：年龄（P＜0.001，OR=1.127）、受伤至手术时间（P＜0.001，OR=1.104）、术后开始锻炼时间（P＜0.001，OR=1.064）、是否定期门诊随访（P＜0.001，OR=0.088）是影响肱骨头置换手术疗效的因素。结论：年龄、受伤至手术时间、术后开始锻炼时间、是否定期门诊随访是影响肱骨头置换治疗效果的主要因素。

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	陈春慧
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	陈华

关键词 ： , 肱骨头置换, 危险因素, 肱骨骨折, 回归分析

Abstract：Objective: To explore the influencing factors of humeral head arthroplasty surgery effect. Methods: From January 2010 to January 2014, 52 cases of proximal humeral comminuted fractures with treatment of the humeral head arthroplasty were selected. The 8 indicators that may affect humeral head arthroplasty surgery effectiveness were recorded and analyzed by logistic regression analysis, including age, sex, cause of injury, type of fracture, time from injury to surgery, time to start exercising after surgery, whether the patient is regularly followed-up and whether the patient is accompanied by osteoporosis. ASES scoring was applied to assess the outcome of the treatment. Results: Univariate analysis showed that there’s statistical difference (P<0.05) in age, time from injury to surgery, time to start exercising after surgery, whether the patient is regularly followed-up and whether the patient is accompanied by osteoporosis. There’s no significant difference (P>0.05) in gender, cause of injury and type of fracture. Multivariate logistic regression analysis showed that age (P<0.001, OR=1.127), time from injury to surgery (P<0.001, OR=1.104), time to start exercising after surgery (P<0.001, OR=1.064), and regular follow-up (P<0.001, OR=0.088) were the influencing factors, but osteoporosis was not (P=0.573, OR=1.102). Conclusion: Age, time from injury to surgery, time to start exercising after surgery and regular follow-up may be the chief factors affecting humeral head arthroplasty surgery effect, which should be taken into consideration for individualized treatment.

Key words： humeral head arthroplasty surgery risk factors humeral fractures regression analysis

收稿日期: 2017-02-20

通讯作者: 陈华，主任医师，Email：chenhua_fey@163.com。

作者简介: 陈春慧（1990-），男，浙江温州人，住院医师，硕士

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I3/189

[1] LAUNONEN A P, SUMREIN B O, LEPOLA V. Treatment of proximal humerus fractures in the elderly[J]. Duodecim, 2017, 133(4): 353-358.
[2] KANNUS P, PALVANEN M, NIEMI S, et al. Rate of proximal humeral fractures in older Finnish women between 1970 and 2007[J]. Bone, 2009, 44(4): 656-659.
[3] BOYER E, MENU G, LOISEL F, et al. Cementless and locked prosthesis for the treatment of 3-part and 4-part proximal humerus fractures: prospective clinical evaluation of hemi- and reverse arthroplasty[J]. Eur J Orthop Surg Traumatol, 2017, 27(3): 301-308.
[4] RODIA F, THEODORAKIS E, TOULOUPAKIS G, et al. Fixation of complex proximal humeral fractures in elderly patients with a locking plate: A retrospective analysis of radiographic and clinical outcome and complications[J]. Chin J Traumatol, 2016, 5(80): 860-867.
[5] NEER C S 2nd. Displaced proximal humeral fractures. I. Classification and evaluation[J]. J Bone Jt Surg Am, 1970, 52(6): 1077-1089.
[6] PIITULAINEN K, PALONEVA J, YLINEN J, et al. Reliability and validity of the Finnish version of the American shoulder and elbow surgeons standardized shoulder assessment form, patient self-report section[J]. BMC Musculoskelet Disord, 2014, 15: 272.
[7] Raiss P, Edwards T B, Collin P, et al. Reverse shoulder arthroplasty for malunions of the proximal part of the humerus (type-4 fracture sequelae)[J]. J Bone Jt Surg Am, 2016, 98(11): 893-899.
[8] Park Y K, Kim S H, Oh J H. Intermediate-term outcome of hemiarthroplasty for comminuted proximal humerus frac-tures[J]. J Shoulder Elbow Surg, 2016, 26(1): 85-91.
[9] URI O, BECKLES V, HIGGS D, et al. Increased-offset reverse shoulder arthroplasty for the treatment of failed post-traumatic humeral head replacement[J]. J Shoulder Elbow Surg, 2014, 23(3): 401-408.
[10] PARKS D L, CASAGRANDE D J, SCHRUMPF M A, et al. Radiographic and clinical outcomes of total shoulder arthroplasty with an all-polyethylene pegged bone ingrowth glenoid component: prospective short- to medium-term follow-up[J]. J Shoulder Elbow Surg, 2016, 25(2): 246-255.
[11] MERKLE T P, BECKMANN N, BRUCKNER T, et al. Shoulder joint replacement can improve quality of life and outcome in patients with dysmelia: a case series[J]. BMC Musculoskelet Disord, 2016, 17: 185.
[12] IAGULLI N D, FIELD L D, HOBGOOD E R, et al. Surface replacement arthroplasty of the humeral head in young, active patients: midterm results[J]. Orthop J Sports Med, 2016, 2(1): 23-25
[13] 吴鹏, 郎俊哲, 刘扬波, 等. 全膝关节置换术股骨远端外翻角影响因素探讨[J]. 温州医科大学学报, 2016, 46(12): 878-882.
[14] BEAUDREUIL J, OSTERTAG A, LASBLEIZ S, et al. Efficacy of dynamic humeral centering according to NEER test results: a stratified analysis of a randomized-controlled trial [J]. Int J Rehabil Res, 2015, 38(1): 81-83.
[15] LAVER L, GARRIGUES G E. Avoiding superior tilt in reverse shoulder arthroplasty: a review of the literature and technical recommendations[J]. J Shoulder Elbow Surg, 2014, 23(10): 1582-1590.