Department of Trauma Surgery, Cantonal Hospital Lucerne, Switzerland.
Arch Orthop Trauma Surg. 2010 Nov;130(11):1397-403. doi: 10.1007/s00402-010-1088-1. Epub 2010 Mar 18.
The ButtonFix(®) system represents a new angular stable percutaneous fixation device for stabilisation of fractures of the proximal humerus. The purpose of this study was to present a preliminary report of the radiological and clinical outcome after minimally invasive stabilisation of selected proximal humerus fractures with the ButtonFix(®).
Seventeen patients with fractures of the proximal humerus were treated in our department with the ButtonFix(®) system. The mean final follow-up was performed 19 months postoperatively. Follow-up included assessment of postoperative reposition, range of motion, the DASH score, the Constant-Murley score, and the Short Form 36 (SF36).
Twelve patients showed anatomical head-to-shaft angles, four revealed minor valgus replacement, and one minor varus replacement. In one patient unplanned revision surgery was necessary due to early secondary fracture dislocation requiring ORIF with an angular stable form plate. Implant removal was performed after 6 weeks in all patients. At the final follow-up, mean range of motion was: flexion 135°, extension 45°, abduction 142°, internal rotation 51°, and external rotation 62°. The mean Constant-Murley score was 70. The mean DASH score was 26 points and the average SF36 score was 76 points. One patient showed radiological signs of avascular necrosis.
The ButtonFix(®) system represents a valuable tool in the treatment of proximal humeral fractures with results indicating fewer complications compared to prior percutaneous fixation devices. Moreover, the ButtonFix(®) seems to be able to maintain reduction even in elderly patients with potentially reduced bone mass.
ButtonFix(®)系统是一种新型的角稳定经皮固定装置,用于稳定肱骨近端骨折。本研究的目的是报告采用 ButtonFix(®)微创固定治疗选定的肱骨近端骨折的放射学和临床结果。
我们科室采用 ButtonFix(®)系统治疗了 17 例肱骨近端骨折患者。平均最终随访时间为术后 19 个月。随访包括评估术后复位、活动范围、DASH 评分、Constant-Murley 评分和 SF36 评分。
12 例患者的头干角解剖学角度,4 例患者出现轻度外翻置换,1 例患者出现轻度内翻置换。1 例患者因早期继发性骨折脱位需要切开复位内固定而计划外进行了翻修手术,采用角稳定型接骨板。所有患者均在 6 周后取出植入物。在最终随访时,平均活动范围为:屈曲 135°,伸展 45°,外展 142°,内旋 51°,外旋 62°。平均 Constant-Murley 评分为 70 分。平均 DASH 评分为 26 分,平均 SF36 评分为 76 分。1 例患者出现了缺血性坏死的影像学征象。
ButtonFix(®)系统是治疗肱骨近端骨折的一种有价值的工具,其结果表明与以前的经皮固定装置相比,并发症更少。此外,ButtonFix(®)似乎能够维持复位,即使在骨量可能减少的老年患者中也是如此。