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预塑形解剖锁定钢板治疗肱骨劈裂型大结节骨折:68例前瞻性研究,平均随访2.5年。

Application of pre-contoured anatomic locking plate for treatment of humerus split type greater tuberosity fractures: A prospective review of 68 cases with an average follow-up of 2.5 years.

作者信息

Hu Chuanzhen, Zhou Kaihua, Pan Fugen, Zhai Qilin, Wen Weifeng, He Xiaojian

机构信息

Department of Orthopaedic Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai 200072, China; Institute of Bone Tumor Affiliated to Tongji University, School of Medicine, Shanghai 200072, China.

Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China.

出版信息

Injury. 2018 Jun;49(6):1108-1112. doi: 10.1016/j.injury.2018.04.013. Epub 2018 Apr 18.

Abstract

OBJECTIVES

Although various implants exist for 3- and 4-part proximal humerus fractures, few implants are appropriate for humerus split type greater tuberosity fractures. The goal of this study was to assess the efficacy of pre-contoured anatomic locking plate for humerus split type greater tuberosity fractures.

METHODS

A retrospective review of 68 patients with humerus split type greater tuberosity fractures treated with open reduction and internal fixation using anatomic locking plates between January 2014 and October 2016. Postoperatively, patient radiographs, functional results, and complications were reviewed.

RESULTS

All patients got a mean follow-up of 30.5 months (range 14-46 months). Average fracture healing time was 9.4 weeks (range, 8-14 weeks). Overall mean Constant score was 86.8% (range, 70%-96%). The result was rated as excellent in 25 patients (Constant score: 92.1%), good in 38 patients (Constant score: 85.3%) moderate in 5 patients (Constant score: 71.8%) and poor in 0 cases. The excellent-good rate was 92.6%. No recurrence of dislocation occurred in the 30 cases with shoulder dislocation. All fractures healed without the complications of wound infection, subacromial impingement syndrome, nonunion, secondary displacement, and implant loosening.

CONCLUSION

Pre-contoured anatomic locking plate is a reliable option in treating humerus split type greater tuberosity fractures as it provides stable fixation with an early return to function. The surgical technique is easy and efficient.

摘要

目的

尽管存在多种用于治疗三部分和四部分近端肱骨骨折的植入物,但很少有植入物适用于肱骨大结节劈裂型骨折。本研究的目的是评估预塑形解剖锁定钢板治疗肱骨大结节劈裂型骨折的疗效。

方法

回顾性分析2014年1月至2016年10月期间68例采用解剖锁定钢板切开复位内固定治疗的肱骨大结节劈裂型骨折患者。术后对患者的X线片、功能结果及并发症进行评估。

结果

所有患者平均随访30.5个月(范围14 - 46个月)。平均骨折愈合时间为9.4周(范围8 - 14周)。Constant评分总体平均值为86.8%(范围70% - 96%)。结果评定为优的患者25例(Constant评分:92.1%),良的患者38例(Constant评分:85.3%),可的患者5例(Constant评分:71.8%),差的患者0例。优良率为92.6%。30例肩关节脱位患者均未出现脱位复发。所有骨折均愈合,未出现伤口感染、肩峰下撞击综合征、骨不连、二次移位及植入物松动等并发症。

结论

预塑形解剖锁定钢板是治疗肱骨大结节劈裂型骨折的可靠选择,因其能提供稳定固定并使患者早期恢复功能。手术技术简便有效。

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