Choi Sungwook, Seo Kyu-Bum, Kwon Yong Suk, Kang Hyunseong, Cho Changhee, Rho Joseph Y
Acta Orthop Belg. 2019 Dec;85(4):429-436.
The purpose of this study is to evaluate radiological, clinical results and complication rates of dual plate fixation for severe metaphyseal comminuted fracture of proximal humerus. 21 patients who have proximal humerus fractures with impaired posteromedial buttress were enrolled. Fractures were treated with dual plate technique using Proximal Humeral Locking plate and Variable Angle Plate. Radiographic results were analyzed based on duration of union. For evaluation of the degree of anatomical reduction, neck shaft angle on the anteroposterior view was measured by simple plain radiography using the Paavolainen method, while anterior-posterior angulation was measured on the axial view. Degree of anatomic reduction was good in 17 patients (80.95%), fair in 3 patients (14.28%), and poor in 1 patient (4.77%). One case of impingement, and one case of avascular necrosis were noted. The dual plate technique provides stable fixation and satisfactory clinical and radiological results for severely comminuted metaphyseal fracture of the proximal humerus.
本研究旨在评估双钢板固定治疗肱骨近端严重干骺端粉碎性骨折的影像学、临床结果及并发症发生率。纳入21例肱骨近端骨折且后内侧支柱受损的患者。采用肱骨近端锁定钢板和可变角度钢板的双钢板技术治疗骨折。根据骨折愈合时间分析影像学结果。为评估解剖复位程度,采用Paavolainen法通过简单的X线平片测量前后位片上的颈干角,同时在轴位片上测量前后成角。17例患者(80.95%)解剖复位良好,3例患者(14.28%)复位尚可,1例患者(4.77%)复位较差。记录到1例撞击和1例缺血性坏死病例。双钢板技术为肱骨近端严重粉碎性干骺端骨折提供了稳定的固定以及满意的临床和影像学结果。