Department of Orthopedics, Mayo Institute of Medical Sciences, C 1/157, Vishesh Khand, Gomti Nagar, Barabanki, 226010, Uttar Pradesh, India,
J Orthop Traumatol. 2014 Jun;15(2):117-22. doi: 10.1007/s10195-014-0290-2. Epub 2014 Apr 1.
The aim of this retrospective study was to compare outcomes and complications of displaced fractures of the shaft of the humerus treated with limited-contact dynamic compression plates (LCDCPs) and locking compression plates (LCPs).
Two hundred and twelve patients with displaced fractures of the shaft of the humerus, treated with plate osteosynthesis from January 2005 to December 2009 were reviewed. One hundred and two patients (group A) were treated with LCDCP osteosynthesis and 110 patients (group B) were treated with LCP osteosynthesis. Clinical and radiological assessments were made at monthly intervals for the first 6 months and then at 2-month intervals for the next 6 months. Primary outcome measures like operative time, duration of hospital stay, time to fracture union, union rate and secondary outcome measures (functional outcome and complications such as infection, malunion, delayed union, nonunion, implant failure and iatrogenic radial nerve palsy) were compared between both groups. The ULCA scoring system and Mayo elbow performance index (MEPI) were used to assess shoulder and elbow functions, respectively. Rodriguez-Merchan criteria were used to assess the functional outcomes of the fracture fixation.
There was no significant difference found between the two groups in terms of primary outcome measures. According to Rodriguez-Merchan criteria, comparison of functional outcomes of both groups showed insignificant difference (p = 0.48). There was no significant difference found between the two groups regarding mean ULCA score (p = 0.34) and mean MEPI sore (p = 0.54). In terms of complications, no significant difference was found between the two groups.
This study concludes that the principle of fracture fixation was more important than plate selection in fractures of the shaft of the humerus.
Level 3.
本回顾性研究旨在比较采用有限接触动力加压钢板（LCDCP）和锁定加压钢板（LCP）治疗肱骨干移位骨折的结果和并发症。
对 2005 年 1 月至 2009 年 12 月采用钢板内固定治疗的 212 例肱骨干移位骨折患者进行了回顾性分析。102 例患者（A 组）采用 LCDCP 钢板固定，110 例患者（B 组）采用 LCP 钢板固定。在最初的 6 个月内每月进行临床和影像学评估，之后的 6 个月内每 2 个月进行一次评估。比较两组患者的主要预后指标，如手术时间、住院时间、骨折愈合时间、愈合率，以及次要预后指标（功能结果和并发症，如感染、畸形愈合、延迟愈合、不愈合、内固定失败和医源性桡神经麻痹）。采用 ULCA 评分系统和 Mayo 肘功能指数（MEPI）分别评估肩部和肘部功能。采用 Rodriguez-Merchan 标准评估骨折固定的功能结果。
两组患者在主要预后指标方面无显著差异。根据 Rodriguez-Merchan 标准，两组间功能结果的比较差异无统计学意义（p=0.48）。两组间平均 ULCA 评分（p=0.34）和平均 MEPI 评分（p=0.54）无显著差异。两组间并发症发生率无显著差异。
本研究表明，对于肱骨干骨折，骨折固定的原则比钢板选择更为重要。
3 级。
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