Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Leeds General Infirmary, Clarendon wing Level A, Great George Street, LS1 3EX, Leeds, UK.
J Orthop Surg Res. 2012 Dec 19;7:39. doi: 10.1186/1749-799X-7-39.
The purpose of this study is to evaluate the functional outcome, union and complication rates after surgical treatment of unstable or displaced proximal humeral fractures using the Polarus intramedullary nail, by reviewing our institutional experience and the relevant current literature.
Twenty-seven patients were treated operatively for proximal humeral fracture using the Polarus nail. Fractures were classified according to Neer's classification. A number of parameters including patient demographics, mechanism of injury, operative time, time to union and complications were recorded. Functional outcome was evaluated using the Constant Shoulder Score. A comparison among functional outcomes in patients >60 years in relation to the younger ones was performed. Moreover, a review of the literature was carried out to evaluate the overall union and complication rates.
Two patients lost to follow-up were excluded from the analysis. For the twenty-five patients (mean age: 61 years), the mean follow-up was 36 months. There were 7 complications (28%), including one fixation failure, four protruded screws, one superficial infection and one case of impingement. The union rate was 96% (mean time to union: 4.2 months). The mean Constant score was 74.5 (range: 48-89). Patients under the age of 60 had a better functional outcome compared to patients >60 years of age (p<0.05). From the literature review and from a total of 215 patients treated with a Polarus nail, the mean union rate was 95.8%, the overall reported complication rate, including both minor and major complications, ranged widely from 9.3% up to 70%.
The Polarus nail was found to be an effective implant for stabilisation of proximal humeral fractures. Functional outcome is for the vast majority of the cases excellent or good, but in elderly patients a lower Constant score can be expected.
本研究旨在通过回顾我院的经验和相关文献，评估使用 Polarus 髓内钉治疗不稳定或移位的肱骨近端骨折的功能结果、愈合率和并发症发生率。
对 27 例肱骨近端骨折患者采用 Polarus 钉进行手术治疗。根据 Neer 分类对骨折进行分类。记录了患者人口统计学、损伤机制、手术时间、愈合时间和并发症等参数。使用 Constant 肩部评分评估功能结果。对 >60 岁和 <60 岁患者的功能结果进行了比较。此外，还对文献进行了回顾，以评估总体愈合率和并发症发生率。
有 2 名患者失访，未纳入分析。25 例患者（平均年龄：61 岁）的平均随访时间为 36 个月。有 7 例并发症（28%），包括 1 例固定失败、4 例螺钉突出、1 例浅表感染和 1 例撞击。愈合率为 96%（平均愈合时间：4.2 个月）。平均 Constant 评分为 74.5（范围：48-89）。<60 岁的患者功能结果优于 >60 岁的患者（p<0.05）。从文献回顾和总共 215 例使用 Polarus 钉治疗的患者中，平均愈合率为 95.8%，总体报告的并发症发生率，包括轻微和严重并发症，范围从 9.3%到 70%不等。
Polarus 钉被发现是一种有效的肱骨近端骨折固定植入物。大多数情况下，功能结果是极好或良好的，但在老年患者中，Constant 评分可能较低。
