Clinical outcomes of reverse shoulder arthroplasty:A retrospective study

Tsung-Yu Lin, Yueh-Ching Liu, Wei-Cheng Chen, Chang-Hung Huang, Te-Yang Huang, Yung-Chang Lu*

Formosan Journal of Musculoskeletal Disorders 2018,9:60-66

骨科部 / 脊椎骨科 / 編輯者姓名 682

本研究相關作者

英文摘要

Reverse total shoulder arthroplasty (RSA) has also become popular in Taiwan, however, no related article regarding RSA has been reported in the orthopaedic literature in Taiwan. Purpose: To examine functional outcomes and complications after RSA. Methods: Patients undergoing RSA between March 2015 and March 2017 were reviewed for inclusion in this retrospective study. All patients had rotator cuff arthropathy, fracture malunion with cuff arthropathy, and locked shoulder. Clinical outcomes were evaluated using Constant scores and active range of motion (ROM) of the shoulder joint. Active ROM was evaluated in terms of anterior elevation, abduction, external rotation at 90 degree of abduction, and internal rotation. Constant scores and ROMs were analyzed postoperatively at 6 months and 1 year. Results: Fourteen patients (eight women, six men; average age, 75 years (range, 64 to 89 years) were evaluated with an average follow-up of 13.8 months. The average absolute Constant score at 6 months follow-up was 61.6 ± 10.6 points. Average degree of anterior elevation, abduction, external rotation, and internal rotation improved from 66.4, 27.8, 40, and sacrum, respectively, before surgery to 147.1, 33.9, 84.6, and L4, respectively, postoperatively. However, average external rotation did not improve significantly after surgery (p = 0.0055). Similar results were noted at 1 year follow-up. Two complications (14.3%) were recorded including RSA shoulder dislocation and postoperative acromion fracture. Conclusion: RSA provides reliable pain relief and return of shoulder function in patients with rotator cuff arthropathy.

本文摘要

另一特性是小兒骨頭的再塑性很高而再塑性與許多因子有關,如年齡愈小生長速度愈快,骨折位置越接近末稍則骨頭的再塑性就愈大,這意味著這樣的骨折越不需要完全的復位即可完全恢復。
通常在嬰兒時期骨折很少需要開刀治療,只有在如影響關節不穩定骨折或某些等級的生長板骨折需要做較精確的復位時,才需要手術固定。

另外一點大家較關心的是骨折何時會癒合,癒合時間的長短與病患年齡、骨頭大小與所在位置都有關。一般而言,小的骨頭如指骨或掌骨約需四週,中型股如前臂骨約需六週,大型骨如肱骨、小腿骨約需八至十週,至於最長的大腿骨則需八至十週, 而生長板的癒合約只需骨折癒合一半的時間。
小兒骨折一般亦不會有僵硬的情形通常在骨折癒合後較不需要復健即可於短時間恢復。

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