Koukakis Athanasios, Apostolou Constantinos D, Taneja Tarun, Korres Dimitrios S, Amini Alexander
Orthopaedic Department, Princess Alexandra Hospital, Harlow, UK.
Clin Orthop Relat Res. 2006 Jan;442:115-20. doi: 10.1097/01.blo.0000194678.87258.6e.
Proximal humeral fractures, especially in elderly patients, remain a challenging problem for the surgeon because the complication rate for these fractures still remains high. The internal locked system (PHILOS) plate is a new device used for proximal humerus fracture fixation is designed to decrease the high complication rate. We prospectively evaluated our early experience using this system. Twenty patients with fractures of the proximal humerus were treated with a PHILOS plate from September 2001 to January 2004 at Princess Alexandra Hospital in Harlow, UK. Functional assessment was done using the Constant shoulder score. Two patients who had brachial plexus injury were evaluated only with the visual analogue score because we thought that the Constant objective assessment would be unreliable. Complications were monitored. The mean Constant score was found to be 76.1% (range, 30-100%). The preliminary results seem to be satisfactory. According to our experience, the plate design provides stable fixation with a good functional outcome and eliminates most hardware problems such as failure and impingement syndrome. The PHILOS plate is suitable for the majority of fractures providing that the correct surgical technique is used.
Therapeutic study, level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.
肱骨近端骨折,尤其是在老年患者中,对外科医生来说仍然是一个具有挑战性的问题,因为这些骨折的并发症发生率仍然很高。肱骨近端锁定接骨板系统(PHILOS)是一种用于肱骨近端骨折固定的新型装置,旨在降低高并发症发生率。我们前瞻性地评估了使用该系统的早期经验。2001年9月至2004年1月期间,英国哈洛的亚历山德拉公主医院对20例肱骨近端骨折患者使用PHILOS接骨板进行了治疗。使用康斯坦特肩关节评分进行功能评估。两名臂丛神经损伤患者仅采用视觉模拟评分进行评估,因为我们认为康斯坦特客观评估不可靠。对并发症进行了监测。发现平均康斯坦特评分为76.1%(范围为30 - 100%)。初步结果似乎令人满意。根据我们的经验,该接骨板设计能提供稳定的固定,功能结果良好,并消除了大多数硬件问题,如接骨板断裂和撞击综合征。如果使用正确的手术技术,则PHILOS接骨板适用于大多数骨折。
治疗性研究,IV级(病例系列)。有关证据水平完整描述,请参阅作者指南。