肩關節置換及其復健

Shoulder Replacement and Rehabilitation

畢柳鶯(Leou-Ing Bih)

《物理治療學會雜誌》 11卷 (1986/11) Pp. 26-33

https://doi.org/10.29617/JPT.198611.0005

摘要

本文對肩部人工關節的發展史作一完整的回顧，從中瞭解到Neer型以那些優點脫穎而出，成為目前最普遍被採用者；並討論依據不同病理變化、手術方法及肩部生物力學如何給病人最安全、有效的復健治療。最後列舉國外肩關節置換之效果及遭遇之併發症，作為參考。

並列摘要

Some patients with degenerative, rheumatoid, and traumatic diseases of the glenohumeral joint require a surgical procedure primarily for relief of pain and secondarily for achieving better function. Humeral head resection and arthrodesis greatly limit glenohumeral motion, while they may not eliminate all the discomfort. Humeral head replacement designed in 1951 can give complete pain relief and restoration of good function in patients with intact glenoid and good shoulder muscles. A unconstrained total replacement protheses designed by Neer in 1974 can give exellent results for patients with destroyed glenoid and mild or moderate impaired rotator cuff. For patients with nonfunctioning rotator cuff, fixed-fulcrum constrained protheses can be used to replace the rotater cuff mechanism that stabilizes the humeral or prothetic head on the shallow glenoid.
The shoulder is designed for mobility rather than weight bearing, postoperatively, early movement is necessary to promote return of optimun function. Self-assisted passive motion of shoulder is started on the 5th postoperative day. Two weeks after operation, gentle isometric muscle-strengthening exercises are added for muscles that were not surgically viotated. Active or active-assisted range-of-motion exercises are given as home program during 4 to 6 weeks after surgery. Vigorous stretching and isotonic muscle strengthening exercises are usually begun 6 weeks to 2 months after surgery. The exercise program should be continued for at least 6 months, continuing improvement is the rule for as long as 6 months after surgery and occasionally into the second postoperative year.

並列關鍵字

Shoulder arthroplasty ； Rehabilitntion