Liu Qing-he, Sun Wei, Zhou Jun-lin, Ren Xiao-bao, Lu Tie, Shan Lei, Liu Yang
Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, No 8, Gongti South Road, Chaoyang District, Beijing, 100020, People's Republic of China.
Eur J Orthop Surg Traumatol. 2014 May;24(4):467-74. doi: 10.1007/s00590-013-1229-7. Epub 2013 May 21.
The optimal surgical treatment for displaced proximal humeral fractures continues to be controversial. One of the new treatment options is the minimally invasive intramedullary nail. The purpose of this study was to evaluate the functional outcome of using the TRIGEN proximal humeral nail (PHN) for the treatment of displaced proximal humeral fractures in elderly patients. From January 2004 to December 2008, 64 elderly patients (age > 60 years old) with displaced proximal humeral fractures were treated using TRIGEN PHN. A complete 12-month postoperative follow-up was available for 54 patients. The study cohort included two-part (29 shoulders), three-part (22 shoulders), and four-part (3 shoulders) Neer classification fracture types. The Constant-Murley score was used to assess functional outcome. Radiological outcomes were evaluated, and all complications were recorded. All fractures were united. The Constant-Murley score data indicated that the patients experienced improvement from 6 to 12 months postoperatively. The mean absolute Constant-Murley score on the injured side increased from 71.2 ± 11.2 points at 6 months to 82.4 ± 16.4 points at 12 months (P = 0.01). The mean neck-shaft angle 1 year after surgery was 125° ± 8.1° (95°-140°). Secondary complications were minimal and observed in only 6 of 54 patients. In conclusion, the TRIGEN intramedullary humeral nail is effective for the treatment of proximal humeral fractures.
肱骨近端移位骨折的最佳手术治疗方法仍存在争议。新型治疗选择之一是微创髓内钉。本研究的目的是评估使用TRIGEN肱骨近端髓内钉（PHN）治疗老年患者肱骨近端移位骨折的功能结局。2004年1月至2008年12月，64例肱骨近端移位骨折的老年患者（年龄>60岁）接受了TRIGEN PHN治疗。54例患者获得了完整的术后12个月随访。研究队列包括Neer分型中的两部分骨折（29例）、三部分骨折（22例）和四部分骨折（3例）。采用Constant-Murley评分评估功能结局。评估影像学结果，并记录所有并发症。所有骨折均愈合。Constant-Murley评分数据表明，患者术后6至12个月病情有所改善。患侧Constant-Murley评分的平均绝对值从6个月时的71.2±11.2分增加到12个月时的82.4±16.4分（P=0.01）。术后1年平均颈干角为125°±8.1°（95°-140°）。次要并发症极少，仅在54例患者中的6例中观察到。总之，TRIGEN髓内肱骨钉治疗肱骨近端骨折有效。
