动力锁定螺钉（DLS）——可减少肱骨近端骨折中二次螺钉穿孔的发生。
Dynamic-locking-screw (DLS)-leads to less secondary screw perforations in proximal humerus fractures.
作者信息
Freude Thomas, Schroeter Steffen, Plecko Michael, Bahrs Christian, Martetschlaeger Frank, Kraus Tobias M, Stoeckle Ulrich, Doebele Stefan
机构信息
Department of Traumatology and Reconstructive Surgery, BG Unfallklinik, Eberhard Karls Universitaet Tuebingen, Schnarrenbergstrasse 95, 72076 Tuebingen, Germany.
出版信息
BMC Musculoskelet Disord. 2014 Jun 4;15:194. doi: 10.1186/1471-2474-15-194.
BACKGROUND
Loss of reduction and screw perforation causes high failure rates in the treatment of proximal humerus fractures. The purpose of the present study was to evaluate the early postoperative complications using modern Dynamic Locking Screws (DLS 3.7) for plating of proximal humerus fractures.
METHODS
Between 03/2009 and 12/2010, 64 patients with acute proximal humerus fractures were treated by angular stable plate fixation using DLSs in a limited multi-centre study. Follow-up examinations were performed three, six, twelve and twenty-four weeks postoperatively and any complications were carefully collected.
RESULTS
56 of 64 patients were examined at the six-month follow-up. Complications were observed in 12 patients (22%). In five cases (9%), a perforation of the DLS 3.7 occurred.
CONCLUSIONS
Despite the use of modern DLS 3.7, the early complications after plating of proximal humerus fractures remain high. The potential advantage of the DLS 3.7 regarding secondary screw perforation has to be confirmed by future randomized controlled trials.
背景
复位丢失和螺钉穿孔导致肱骨近端骨折治疗的失败率较高。本研究的目的是评估使用现代动力锁定螺钉（DLS 3.7）治疗肱骨近端骨折术后早期并发症情况。
方法
在2009年3月至2010年12月期间，一项多中心有限研究中，64例急性肱骨近端骨折患者采用DLS进行角稳定钢板固定治疗。术后3周、6周、12周和24周进行随访检查，并仔细收集任何并发症。
结果
64例患者中有56例在6个月随访时接受检查。12例患者（22%）出现并发症。5例（9%）发生DLS 3.7穿孔。
结论
尽管使用了现代DLS 3.7，肱骨近端骨折钢板固定术后早期并发症发生率仍然较高。DLS 3.7在继发性螺钉穿孔方面的潜在优势有待未来随机对照试验证实。
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