Shu Ying, Chen Meiji, Yu Weiguang, Ge Zhe, Hu Hao, Zhang Xinchao, Zeng Xianshang, Liu Xiangzhen
Department of Anesthesiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Qiaokou District, Wuhan, China.
Ying Shu and Meiji Chen contributed equally to this work.
Geriatr Orthop Surg Rehabil. 2021 Mar 4;12:2151459321992666. doi: 10.1177/2151459321992666. eCollection 2021.
The aim of this retrospective study was to evaluate the outcomes of older patients with 2-part proximal humerus fractures (PHFs) with medial column disruption stabilized using a proximal humeral internal locking system (PHILOS) plate plus oblique insertion of autologous fibula as a primary procedure.
Data involving 112 patients (112 shoulders) sustaining 2-part PHFs with medial column disruption treated with PHILOS plate plus oblique insertion of autologous fibula as a primary procedure during 2012-2019 were identified. The median follow-up was 36 months (range: 11.2-43.5 months). The primary endpoint was the Constant scores and American Shoulder and Elbow Surgeons (ASES) scores. The secondary endpoint was the main orthopedic complication rate.
The median Constant and ASES scores were 78 (range, 52-95) and 77 (range, 62-96) at the final follow-up, respectively. The main orthopedic complication rate was 10.7% (12/112). Twelve orthopedic complications in 8 patients were detected, and they involved loss of reduction, varus collapse, aseptic loosening, mal-union, revision, and intolerable shoulder pain. Of these complications, 3 (2.6%) involved loss of reduction, 2 (1.7%) involved varus collapse, 3 (2.6%) involved aseptic loosening, 1 (0.8%) involved mal-union, 2 (1.7%) required revision surgery, and 1 (0.8%) presented intolerable shoulder pain.
PHILOS plate plus oblique insertion of autologous fibula as a primary procedure may yield good functional outcomes and a low rate of the main orthopedic complications.
本回顾性研究的目的是评估采用肱骨近端锁定接骨板系统（PHILOS）钢板加自体腓骨斜向植入作为主要手术方式治疗合并内侧柱破坏的老年肱骨近端二部分骨折（PHF）的疗效。
确定了2012年至2019年间112例（112肩）接受PHILOS钢板加自体腓骨斜向植入作为主要手术方式治疗的合并内侧柱破坏的肱骨近端二部分骨折患者的数据。中位随访时间为36个月（范围：11.2 - 43.5个月）。主要终点是Constant评分和美国肩肘外科医师学会（ASES）评分。次要终点是主要骨科并发症发生率。
末次随访时，Constant评分和ASES评分的中位数分别为78分（范围52 - 95分）和77分（范围62 - 96分）。主要骨科并发症发生率为10.7%（12/112）。在8例患者中检测到12例骨科并发症，包括复位丢失、内翻塌陷、无菌性松动、畸形愈合、翻修手术和难以忍受的肩部疼痛。其中，3例（2.6%）出现复位丢失，2例（1.7%）出现内翻塌陷，3例（2.6%）出现无菌性松动，1例（0.8%）出现畸形愈合，2例（1.7%）需要翻修手术，1例（0.8%）出现难以忍受的肩部疼痛。
PHILOS钢板加自体腓骨斜向植入作为主要手术方式可能产生良好的功能结局和较低的主要骨科并发症发生率。
