中文摘要：

目的探讨肱骨近端骨折行半肩关节置换术后的护理与康复效果。方法将67例行半肩关节假体置换术的肱骨近端粉碎性骨折患者,术后康复锻炼分为早期、中期和晚期3个阶段,并对患者的功能康复锻炼进行指导。对67例患者进行了平均9个月的随访和功能锻炼指导,按照Neer评分标准进行评价。结果 67例患者中优38例,良18例,可11例,差0例,优良率达83.58%。结论对肱骨近端粉碎骨折肩关节置换术患者,进行精心的护理和规范化的康复指导,是取得患者肩关节良好功能恢复的重要因素之一。

英文摘要：

Background Proximal humeral fracture refers to the fractures within surgical neck of humerus and at the positions above it,and such fracture cases accounts for 4%-5% of all fracture cases;Most of proximal humeral fractures are complicated and unstable fractures with displacements and mainly occur among the elder population.At present,plaster external fixation or open reduction and internal fixation (ORIF)therapy is mainly adopted in most of hospitals.However,majority of scholars believe that,when an elderly patient suffers from 4 parts of proximal humeral fractures,in particular when such fracture is accompanied with comminuted humeral head fracture or dearticulation,blood supply to humeral head has suffered non-reversible injury;In case of failure after Phase I internal fixation,performance of joint replacement at Phase I will affect the operation effect and the recovery of shoulder joint functions.For some aged patients,in particular some patients with osteoporosis,their fractures are 3 parts or 4 parts fractures in Neer typing.Although they have received internal/external fixation therapy,it is difficult to obtain satisfactory results in the recovery of shoulder joint functions.For such cases,shoulder arthroplasty is no doubt a effective therapy with more advantage.In terms of range of joint replacement,shoulder arthroplasty is divided into humeral head hemi-arthroplasty and total shoulder arthroplasty. The careful nursing and normalized rehabilitation after shoulder arthroplasty has been paid more and more attention.The postoperative standardized and continuous rehabilitation is one of the significant factors that may determine whether the shoulder joint functions can be recovered to the maximum extent.During the period from January 2004 to June 2013,our department performed half shoulder joint prosthesis replacement for 67 cases with shoulder replacement indications. Through careful peri-operative nursing, no case had complication;In addition,after the patients have been discharged from hospital,our departme