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螺旋 PHILOS 板固定后的肩部功能。

Shoulder function after helical long PHILOS plate.

机构信息

Department of Trauma Surgery and Orthopedics, Klinikum Stuttgart - Katharinenhospital, Kriegsbergstraße 60, 70174, Stuttgart, Germany.

出版信息

Eur J Orthop Surg Traumatol. 2021 Oct;31(7):1463-1469. doi: 10.1007/s00590-021-02908-2. Epub 2021 Feb 24.

Abstract

BACKGROUND

In order to minimize the risk of damaging the radial nerve while using a long PHILOS plate for proximal humerus fractures, recent studies have proposed twisting the plate in a helical form. This implies a modified surgical approach being yet unclear whether it leads to different middle to long-term shoulder function. This study compares the one-year shoulder functional outcomes of both techniques (helical vs. control).

METHODS

In this retrospective comparative study, we analyzed 30 patients that fit the inclusion criteria, being 14 treated with a helical plate and 16 with a conventional straight long PHILOS plate. The primary endpoint was the normalized constant score after a minimum follow up of one year.

RESULTS

Both groups had a good one-year shoulder function, and no significant difference between the normalized constant scores was seen. There was no significant difference in the surgical complications as well.

CONCLUSION

Opting for a helical long PHILOS plate in order to avoid radial nerve damage provided a safe treatment with similarly good one-year shoulder function compared to straight PHILOS plates.

LEVEL OF EVIDENCE

Level 3, Retrospective Cohort Study.

摘要

背景

为了降低使用长 PHILOS 板治疗肱骨近端骨折时损伤桡神经的风险,最近的研究提出将钢板以螺旋形式扭曲。这意味着需要修改手术入路,但目前尚不清楚这是否会导致中期至长期的肩部功能不同。本研究比较了这两种技术(螺旋与对照)的一年肩部功能结果。

方法

在这项回顾性比较研究中,我们分析了符合纳入标准的 30 名患者,其中 14 名接受螺旋钢板治疗,16 名接受传统直长 PHILOS 钢板治疗。主要终点是至少随访一年后的归一化常数评分。

结果

两组患者均具有良好的一年肩部功能,归一化常数评分无显著差异。手术并发症也无显著差异。

结论

为避免桡神经损伤而选择螺旋长 PHILOS 板,与直 PHILOS 板相比,提供了一种安全的治疗方法,且一年肩部功能同样良好。

证据水平

3 级,回顾性队列研究。

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