Keener Jay D, Parsons Brad O, Flatow Evan L, Rogers Kenneth, Williams Gerald R, Galatz Leesa M
Department of Orthopaedic Surgery, Washington University/Barnes-Jewish Hospital, St Louis, MO 63110, USA.
J Shoulder Elbow Surg. 2007 May-Jun;16(3):330-8. doi: 10.1016/j.jse.2006.09.006. Epub 2007 Feb 22.
The purpose of this study is to report the outcomes after closed or percutaneous reduction with percutaneous fixation of displaced proximal humeral fractures. This study included 35 patients from 3 institutions. Of these, 27 were followed up for a minimum of 1 year after surgery. The mean age at injury was 61 years. There were seven 2-part, eight 3-part, and twelve valgus-impacted 4-part proximal humeral fractures. All fractures were reduced and stabilized with percutaneous techniques only. The mean duration of follow-up was 35 months. All fractures healed after the index procedure. The mean pain score on a visual analog scale was 1.4. The mean American Shoulder and Elbow Surgeons and Constant scores were 83.4 and 73.9, respectively. Four patients healed with malunion, and in four, glenohumeral joint osteoarthritis developed. Fracture type, age, malunion, or osteoarthritis had no significance influence on measured outcomes. Percutaneous treatment of selected proximal humeral fractures results in predictable union and good clinical results with a low rate of complications.
本研究的目的是报告移位型肱骨近端骨折经闭合或经皮复位及经皮固定后的治疗结果。本研究纳入了来自3家机构的35例患者。其中,27例患者术后至少随访1年。受伤时的平均年龄为61岁。有7例二部分骨折、8例三部分骨折和12例外翻嵌插型四部分肱骨近端骨折。所有骨折均仅采用经皮技术进行复位和固定。平均随访时间为35个月。所有骨折在初次手术后均愈合。视觉模拟量表的平均疼痛评分为1.4。美国肩肘外科医师学会(American Shoulder and Elbow Surgeons)评分和康斯坦特(Constant)评分的平均值分别为83.4和73.9。4例患者骨折愈合不佳,4例出现盂肱关节骨关节炎。骨折类型、年龄、骨折愈合不佳或骨关节炎对测量结果均无显著影响。经皮治疗部分选定的肱骨近端骨折可实现可预测的愈合,临床效果良好,并发症发生率低。