Hashmi F R, Mayr Edgar
Warwick Hospital, Lakin Road, Warwickshire, CV34 5BW, UK.
Department of Trauma, Hand and Reconstructive Surgery, Klinikum Augsburg, Stenglinstr.2, 86156, Augsburg, Germany.
Eur J Orthop Surg Traumatol. 2016 Dec;26(8):831-836. doi: 10.1007/s00590-016-1817-4. Epub 2016 Jul 26.
The objective of this study was to assess the clinical outcome of displaced proximal humerus fracture treated with a new locking blade nail.
This prospective study included a series of 92 patients with acute fracture of the proximal humerus treated in one hospital level I trauma centre with locking blade nail between December 2010 and December 2013. According to the Neer classification, all fractures were two- to four-part fractures. Age adopted Constant score, DASH and visual analogue scores were used as outcome measures.
A total of 92 patients were enrolled in the study. However, 29 patients were excluded due to loss to follow-up and death. Ultimately, 63 patients were available for final follow-up and data analysis. The mean duration of follow-up was 22 months (range 16-48 months). On average at 1 year, all fractures had united. The mean weighted Constant score was 84.2 % and the median disabilities of the arm, shoulder and hand (DASH) score was 26, the range of elevation was 115 and range of abduction was 97. The head shaft angle was 130, and pain visual analogue was 1.6. We found that 5 of the 63 patients (8 %) demonstrated complications. Two patients (3 %) displayed secondary displacement and require device removal. Two patients (3 %) had impingement due to prominent metal work, and one patient had a superficial wound infection which was treated with a course of antibiotics.
Our study shows excellent results with new locking blade nail for displaced proximal humerus fractures. We think the locking blade nail offers stiff triangular fixation of the head fragment and support of the medial calcar region to prevent secondary varus collapse.
III.
本研究的目的是评估一种新型锁定接骨板治疗移位型肱骨近端骨折的临床疗效。
这项前瞻性研究纳入了2010年12月至2013年12月期间在一家一级创伤中心接受新型锁定接骨板治疗的92例急性肱骨近端骨折患者。根据Neer分类，所有骨折均为二部分至四部分骨折。采用Constant评分评估患者年龄，以DASH和视觉模拟评分作为疗效指标。
本研究共纳入92例患者。然而，29例患者因失访和死亡被排除。最终，63例患者可供最终随访和数据分析。平均随访时间为22个月（范围16 - 48个月）。平均1年时，所有骨折均已愈合。平均加权Constant评分为84.2%，上肢、肩部和手部功能障碍（DASH）评分中位数为26，抬高范围为115，外展范围为97。头干角为130，疼痛视觉模拟评分为1.6。我们发现63例患者中有5例（8%）出现并发症。2例患者（3%）出现二次移位并需要取出内固定装置。2例患者（3%）因金属部件突出出现撞击，1例患者出现浅表伤口感染，经抗生素治疗。
我们的研究表明新型锁定接骨板治疗移位型肱骨近端骨折效果良好。我们认为锁定接骨板对头骨折块提供了坚固的三角形固定，并支持内侧肱骨距区域以防止继发内翻塌陷。
III级
