Li X, Li F L, Lu Y, Zhu Y M, Guo S Y, Li Y J, Jiang C Y
Department of Sports Medicine,Beijing Jishuitan Hospital, Beijing 100035, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2017 Oct 18;49(5):855-860.
To describe long-term results of locking plate used for the treatment of non-osteoporotic fresh three- and four-part proximal humeral fractures with at least 2 years follow-up.
The functional outcomes and the complications of non-osteoporotic three- and four-part fresh proximal humeral fractures treated with locking plate were assessed retrospectively. The active range of motion, the Constant score, the University of California at Los Angeles (UCLA) shoulder score, the visual analogue score (VAS) were employed to evaluate the postoperative shoulder function, and the radiographic images were taken to evaluate the neck-shaft angle of the proximal humeral and postoperative implant-related complications.
From January 2007 to October 2014, 107 consecutive fresh three- and four-part non-osteoporotic fresh proximal humeral fractures were treated with a locking plate in our department. Among them, 67 patients completed at least 2 years follow-up. The average follow-up time was (43.9±23.3) months (range: 24-108 months). The mean Constant score was 87.1±11.7 (range: 51-100), the mean UCLA score was 30.5±3.9 (range: 18-35), the mean VAS score was 1±2 (range: 0-7). The mean active forward flexion was 159.0°±19.3° (range: 80°-180°), the mean external rotation was 36.8°±19.5°(0°-80°) and the mean internal rotation was T11 level (T2-LS level). There were 11 patients who suffered from complications. Screw perforations were observed in 5 (7.5%) patients, avascular necrosis of the humeral head was observed in 9 (13.4%) patients and traumatic osteoarthritis was observed in 5 (7.5%) patients. Six patients showed two or more complications. There was no significant difference in outcomes when comparing the patients with three- part fractures (31 patients) with those with four-part fractures (36 patients). The rates of complications and avascular necrosis were significantly higher in the four-part fracture group than in the three-part fracture group.
The locking plate is an effective method in treating three- and four-part non-osteoporotic fresh proximal humeral fractures. Strict surgical indication and precise surgical skill are the key points for successful treating non-osteoporotic fresh proximal humeral fractures. There is a higher rate of complications and avascular necrosis of the humeral head in the four-part fractures than in the three-part fractures.
描述锁定钢板治疗非骨质疏松性新鲜三部分和四部分近端肱骨骨折且随访至少2年的长期结果。
回顾性评估采用锁定钢板治疗的非骨质疏松性三部分和四部分新鲜近端肱骨骨折的功能结果及并发症。采用活动范围、Constant评分、加州大学洛杉矶分校（UCLA）肩关节评分、视觉模拟评分（VAS）评估术后肩关节功能，并拍摄X线片评估近端肱骨的颈干角及术后与植入物相关的并发症。
2007年1月至2014年10月，我科连续107例新鲜非骨质疏松性三部分和四部分近端肱骨骨折患者采用锁定钢板治疗。其中，67例患者完成至少2年随访。平均随访时间为（43.9±23.3）个月（范围：24 - 108个月）。Constant评分均值为87.1±11.7（范围：51 - 100），UCLA评分均值为30.5±3.9（范围：18 -
