Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Korea.
Department of Orthopedic Surgery, Bogang Hospital, 102 Wolbae-ro, Dalseo-gu, Daegu 42801, Korea.
Medicina (Kaunas). 2022 Mar 4;58(3):382. doi: 10.3390/medicina58030382.
Background and Objectives: The aim of this study was to evaluate whether device removal in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture improves the clinical outcomes. Materials and Methods: Seventy-one patients who underwent fixed-angle locking plate osteosynthesis of a proximal humerus fracture were included. Thirty-three patients underwent device removal at a mean time of 10.4 months after index surgery (removal group). Thirty-eight patients who retained the device after index surgery (retention group) were included in the control group. Visual analog scale (VAS) pain score, University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM) were evaluated pre- and postoperatively. Results: At the final follow-up, mean UCLA score, ASES score, and all ROMs were significantly higher in the removal group compared to the retention group (p < 0.001). However, no significant difference in mean VAS pain score was observed between the two groups. Comparison of the clinical outcomes before and after device removal surgery showed significant improvement in all clinical scores and ROMs after device removal (p < 0.001). Conclusions: Device removal surgery in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture can result in significant improvement in functional outcomes.
本研究旨在评估在锁定钢板固定治疗肱骨近端骨折的有症状患者中，是否去除内固定装置能改善临床结果。材料与方法：纳入 71 例接受肱骨近端骨折锁定钢板固定治疗的患者。33 例患者在指数手术后平均 10.4 个月（去除组）时去除内固定装置。38 例保留内固定装置的患者（保留组）作为对照组。术前和术后评估视觉模拟评分（VAS）疼痛评分、加利福尼亚大学洛杉矶分校（UCLA）评分、美国肩肘外科医生协会（ASES）评分和活动度（ROM）。结果：末次随访时，去除组的 UCLA 评分、ASES 评分和所有 ROM 均显著高于保留组（p < 0.001）。然而，两组的 VAS 疼痛评分无显著差异。去除内固定装置手术前后的临床结果比较显示，去除内固定装置后所有临床评分和 ROM 均显著改善（p < 0.001）。结论：在肱骨近端骨折锁定钢板固定治疗的有症状患者中，去除内固定装置手术可显著改善功能结果。
