Maes V, Putzeys G
Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium.
Department of Trauma and Orthopaedic Surgery, AZ Groeninge, Kortrijk, Belgium.
BMC Musculoskelet Disord. 2021 Oct 20;22(1):890. doi: 10.1186/s12891-021-04774-9.
Conventional plate osteosynthesis is a valuable treatment option in displaced proximal and/or middle one-third humeral shaft fractures. Nonetheless, this procedure can be complicated by a radial nerve palsy. To date, many surgical techniques have been developed in an attempt to minimize this high-impact complication. A helical plate has the potential to avoid an iatrogenic radial nerve palsy due to its design. This article aims to evaluate safety and functional outcomes of patients treated with a helical plate compared to conventional plate osteosynthesis. In particular healing rates, complications and functional outcome measures.
We retrospectively included all patients with displaced proximal and/or middle one-third humeral shaft fractures who were treated with a helical plate from October 2016 until August 2018 at a single level-1 trauma center (AZ Groeninge, Kortrijk, Belgium). A self-molded long PHILOS plate (DePuy Synthes®) or a pre-contoured A.L.P.S proximal humeral plating system (Zimmer Biomet®) were used. Patient baseline characteristics and standard radiographs were obtained pre- and postoperatively. We retrospectively searched for complications. Patients were reassessed using the Disabilities of the Arm, Shoulder and Hand (DASH), Constant Murley (CMS) and EQ-5D-5L scores with a minimal follow-up of 1 year.
The humeral shaft fractures of all sixteen patients consolidated within 3 months and no iatrogenic radial nerve palsies were observed. One plate had to be removed after 1 year due to a late deep infection. With a minimum follow up of 1 year, the mean DASH score was 22 ± 19 and the mean normalized CMS was 80 ± 19.
Operative treatment of proximal and/or middle one-third humeral shaft fractures with a helical plate is a safe procedure with good to excellent shoulder function at one-year follow-up. Contrary to conventional plate osteosynthesis, a helical plate has the potential to completely avoid a radial nerve palsy, while maintaining similar healing rates and functional outcomes.
Retrospective cohort study. B396201939564 . Registered on 10 MAY 2019.
对于肱骨近端和/或中段三分之一移位骨折，传统钢板接骨术是一种有价值的治疗选择。尽管如此，该手术可能并发桡神经麻痹。迄今为止，已经开发了许多手术技术，试图将这种具有高影响的并发症降至最低。由于其设计，螺旋钢板有可能避免医源性桡神经麻痹。本文旨在评估与传统钢板接骨术相比，使用螺旋钢板治疗的患者的安全性和功能结果。特别是愈合率、并发症和功能结果指标。
我们回顾性纳入了2016年10月至2018年8月在单一的一级创伤中心（比利时科特赖克市AZ Groeninge医院）接受螺旋钢板治疗的所有肱骨近端和/或中段三分之一移位骨折患者。使用了自成型长PHILOS钢板（DePuy Synthes®）或预塑形的A.L.P.S肱骨近端接骨板系统（Zimmer Biomet®）。在术前和术后获取患者的基线特征和标准X线片。我们回顾性地查找并发症。使用手臂、肩部和手部功能障碍（DASH）、Constant Murley（CMS）和EQ-5D-5L评分对患者进行重新评估，最短随访时间为1年。
所有16例患者的肱骨干骨折均在3个月内愈合，未观察到医源性桡神经麻痹。1年后，由于迟发性深部感染，1块钢板不得不取出。最短随访1年时，平均DASH评分为22±19，平均标准化CMS评分为80±19。
使用螺旋钢板对肱骨近端和/或中段三分之一骨折进行手术治疗是一种安全的手术，在1年随访时肩部功能良好至优秀。与传统钢板接骨术相反，螺旋钢板有可能完全避免桡神经麻痹，同时保持相似的愈合率和功能结果。
回顾性队列研究。B396201939564。于2019年5月10日注册。
