人工肩关节置换

人工肩关节置换,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,人工肩关节置换,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,人工肩关节置换,人工肩关节置换,Bone cement Iliac bone,Osteoarticular allograft arthrodesis,Clavicula pro humeral reconstruction,Arthrodesis,Free vascularised fibula graft,Prosthetic arthroplasty,2,人工肩关节置换,Hemiarthroplasty (humeral head replacements),Total shoulder arthroplasty (TSA glenohumeral replacements),3,Hemiarthroplasty,TSA,Unconstrained,Hemi-constrained,Constrained,Ball-cotyla,Inverted type,4,5,人工肩关节置换,Giant cell tumors(GCT),chondroblastoma,Chondrosarcoma,Osteosarcoma,Ewings sarcoma,Fibrosarcoma,Metastatic tumor,. . . . . . . .,6,人工肩关节置换,benign tumor,1 indolent,2 active,3 aggressive,malignant tumor,stage grade location metastatic,IA low in not,IB low out not,IIA high in not,IIB high out not,III any any yes,7,Malawer classification of shoulder girdle resections,8,人工肩关节置换,Intra-articular proximal,humeral resection,TypeA:abductors retained,TypeB:abductors resected,9,Magnetic resonance imaging (MRI),Margin of resection,A margin of 3 to 4cm distal to the,MRI,extent of the tumor is sufficient,and allows a type A resection,10,Margin of resection,Confined to bone,Intramedullary,11,Margin of resection,Extraosseous extension that involves the deltoid, a typeB resection will be required,12,Prosthesis Implantation,Hemiarthroplasty,TSA,B,13,人工肩关节置换,Hemiarthroplasty,TSA,Simlper procedure,Avoid loosening,and instability,Pain relief,Activity,Active range of motion,14,15,Despite,the increased technical difficulty,longer operating time,and potential complications,associated with the glenoid component,TSA appears to be our choice,Choice,16,Rotator cuff,17,Rotator cuff,支点,18,19,人工肩关节置换,type A,resection,Deltoid,Supraspinatus,Rotator cuff,20,15%,21,Dacron tape,22,Enhance tendon anchor(ETA),23,人工肩关节置换,type,B,resection,Obtain stability,Mobilization,(Dacron tape),elbow,hand,24,人工肩关节置换,Passive motion exercise,Active exercises,Active resistive,strengthening exercises,25,人工肩关节置换,Rotator cuff tearing,Postoperative glenohumeral instability,Periprosthetic humeral fracture,26,Thanks,27,谢谢观赏,