Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
J Shoulder Elbow Surg. 2018 Dec;27(12):2159-2166. doi: 10.1016/j.jse.2018.05.033. Epub 2018 Jul 13.
Locking plate fixation appears to be a standard treatment for proximal humeral fracture. Different locking plate designs might result in different radiographic and functional outcomes. The original version of the Proximal Humeral Internal Locking System (PHILOS; DePuy Synthes, Warsaw, IN, USA) occupied the largest volume of the humeral head by screw distribution, whereas the Zimmer Periarticular Locking Plate (ZPLP) system (Zimmer Biomet, Warsaw, IN, USA) occupied the smallest.
We enrolled 50 patients undergoing ZPLP treatment and 50 undergoing PHILOS treatment.
The postoperative amount of impaction was significantly higher using the ZPLP System than using the PHILOS. Subgroup analysis showed that medial calcar support was another critical factor that affected surgical outcomes, especially when using the ZPLP System.
The amount of postoperative impaction was significantly higher when the ZPLP was used compared with the PHILOS locking plate. Medial calcar support is another critical factor that affects surgical outcomes. However, no significant differences in functional outcomes (Constant-Murley score) between the ZPLP System and the PHILOS were noted at the 12-month follow-up.
锁定钢板固定似乎是治疗肱骨近端骨折的标准方法。不同的锁定钢板设计可能会导致不同的影像学和功能结果。最初的 Proximal Humeral Internal Locking System (PHILOS; DePuy Synthes, Warsaw, IN, USA) 通过螺钉分布占据了肱骨头的最大体积，而 Zimmer Periarticular Locking Plate (ZPLP) 系统 (Zimmer Biomet, Warsaw, IN, USA) 占据的最小。
我们纳入了 50 例接受 ZPLP 治疗和 50 例接受 PHILOS 治疗的患者。
ZPLP 系统的术后挤压量明显高于 PHILOS。亚组分析表明，内侧骨嵴支撑是另一个影响手术结果的关键因素，尤其是在使用 ZPLP 系统时。
与 PHILOS 锁定钢板相比，使用 ZPLP 时术后挤压量明显更高。内侧骨嵴支撑是另一个影响手术结果的关键因素。然而，在 12 个月的随访中，ZPLP 系统和 PHILOS 的功能结果（Constant-Murley 评分）没有显著差异。
