Martinez Angel A, Calvo Angel, Cuenca Jorge, Herrera Antonio
Department of Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, Medicine School, University of Zaragoza, Zaragoza, Spain.
J Orthop Surg (Hong Kong). 2011 Aug;19(2):191-3. doi: 10.1177/230949901101900212.
To report 6 patients with periprosthetic humeral fractures treated with open reduction and internal fixation with plate and strut allograft augmentation.
6 women aged 69 to 79 (mean, 73) years underwent open reduction and internal fixation with plate and strut allograft augmentation for periprosthetic humeral fractures (type C) after a fall. They had undergone reverse shoulder arthroplasty for rotator cuff arthropathy. The mean interval between the initial arthroplasty and the fracture was 17 (range, 11-21) months.
The mean follow-up period was 14 (range, 12-16) months. The mean time to union was 5.4 (range, 4-6) months. All fractures united without complications. The mean Constant score at the last follow-up was 64 (range, 56-80). The range of shoulder movement and patient satisfaction were restored to pre-fracture status in all patients, except for one who had more pain in the lateral area of the arm (probably because of soft-tissue irritation by the plate and wires). Three patients had evidence of graft-to-host union and 3 others had graft resorption.
Internal fixation with plate, cable wires and strut allogaft augmentation achieves satisfactory results for periprosthetic humeral fractures.
报告6例采用切开复位钢板内固定及支撑异体骨移植治疗的人工肱骨头周围骨折患者。
6例年龄69至79岁（平均73岁）的女性，因跌倒后发生人工肱骨头周围骨折（C型），接受了切开复位钢板内固定及支撑异体骨移植手术。她们之前因肩袖关节病接受了反式肩关节置换术。初次关节置换术与骨折之间的平均间隔时间为17个月（范围11 - 21个月）。
平均随访期为14个月（范围12 - 16个月）。平均愈合时间为5.4个月（范围4 - 6个月）。所有骨折均愈合，无并发症。末次随访时的平均Constant评分64分（范围56 - 80分）。除1例患者手臂外侧疼痛加重（可能是由于钢板和钢丝刺激软组织）外，所有患者的肩部活动范围和患者满意度均恢复至骨折前状态。3例患者有移植物与宿主骨愈合的证据，另外3例有移植物吸收。
钢板、缆线内固定及支撑异体骨移植对人工肱骨头周围骨折可取得满意疗效。
