Doursounian L, Grimberg J, Cazeau C, Jos E, Touzard R C
Department of Orthopaedic Surgery, Georges Pompidou University Hospital, Paris, France.
J Shoulder Elbow Surg. 2000 Jul-Aug;9(4):279-88. doi: 10.1067/mse.2000.106086.
We describe a novel internal fixation device and report on 26 patients (mean age, 70 years) whose proximal humeral fractures were managed with this technique. The 2-part titanium implant consists of a circular staple impacted into the humeral head cancellous bone and a spigoted diaphyseal stem that inserts into the staple "cup." Of the 26 cases reviewed, 16 had 3-part fractures and 10 had 4-part fractures. Mean follow-up was 25.9 months. In the 16 3-part fractures, the mean active forward elevation was 114 degrees and the results were as follows: excellent, 7; good, 5; fair, 3; poor, 1. In the 10 4-part fracture patients, the mean active forward elevation was 101 degrees and the results were as follows: excellent, 2; good, 4; fair, 3; poor, 1. There were 5 cases of avascular necrosis and 1 case of tuberosity nonunion. Only 2 cases needed conversion to hemiarthroplasty. The new technique should simplify the surgery of these fractures and reduce the need for arthroplasty.
我们描述了一种新型内固定装置，并报告了26例（平均年龄70岁）采用该技术治疗肱骨近端骨折的患者情况。这种两部分式钛植入物包括一个打入肱骨头松质骨的圆形钉以及一个插入钉“杯”中的带榫骨干柄。在回顾的26例病例中，16例为三部分骨折，10例为四部分骨折。平均随访时间为25.9个月。在16例三部分骨折中，平均主动前举角度为114度，结果如下：优7例；良5例；可3例；差1例。在10例四部分骨折患者中，平均主动前举角度为101度，结果如下：优2例；良4例；可3例；差1例。有5例发生缺血性坏死，1例出现结节不愈合。仅2例需要转为半关节置换术。这项新技术应能简化这些骨折的手术操作，并减少关节置换的需求。
