Narayanan V L, Balasubramanian N
Department of Orthopaedics, Saveetha Medical College and University, Chennai, India.
Malays Orthop J. 2018 Jul;12(2):20-24. doi: 10.5704/MOJ.1807.004.
Proximal humerus fracture fixation using plate osteosynthesis depends on the quality of the bone, design of the fixation devices and intra-operative soft tissue dissection. This study evaluates the functional outcome of minimally invasive percutaneous plate osteosynthesis using locking compression plate in proximal humerus fracture treatment. The study was conducted on 30 patients with complex proximal humerus fractures treated by minimally invasive percutaneous plate osteosynthesis using locking compression plate (PHILOS). There were 21 males and 9 females. The average age of our study group was 58.8 years. All the patients were evaluated at six weeks, three months, four months, six months and 12 months following surgery. All patients had fracture union at an average of 13.2 weeks. The mean DASH score at the follow-up was 8.69 (2.5 to 17.16), the average range of flexion was 143.83 degrees (100 to 170 degrees) and abduction was 121.49 degrees (90 to 160 degrees). We had superficial infection in three patients which resolved with a short course of antibiotics. There was excellent outcome in 26 patients, good and fair in two patients each. Proximal humerus fractures treated with minimally invasive percutaneous plate osteosynthesis using locking compression plate with minimal soft tissue dissection, provides good functional outcome and early return of shoulder function.
使用钢板接骨术治疗肱骨近端骨折取决于骨质质量、固定装置的设计以及术中软组织的解剖情况。本研究评估了在肱骨近端骨折治疗中使用锁定加压钢板进行微创经皮钢板接骨术的功能结果。该研究对30例采用锁定加压钢板（PHILOS）进行微创经皮钢板接骨术治疗的复杂肱骨近端骨折患者进行。其中男性21例，女性9例。研究组的平均年龄为58.8岁。所有患者在术后6周、3个月、4个月、6个月和12个月进行评估。所有患者平均在13.2周时骨折愈合。随访时的平均DASH评分为8.69（2.5至17.16），平均屈曲范围为143.83度（100至170度），外展为121.49度（90至160度）。3例患者出现浅表感染，经短期抗生素治疗后痊愈。26例患者结果优秀，2例患者结果良好，2例患者结果一般。采用锁定加压钢板进行微创经皮钢板接骨术治疗肱骨近端骨折，软组织剥离最少，可提供良好的功能结果和早期的肩关节功能恢复。
