Department of Orthopedics and Traumatology, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey.
Department of Orthopedics and Traumatology, Beylikdüzü State Hospital, İstanbul-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 Jun;28(6):824-831. doi: 10.14744/tjtes.2021.99078.
The aim of the study is to evaluate the relationship between plate-screw density (PSD), functional results, and complication rates in the treatment of proximal humerus fractures (PHFs) with proximal humerus locking anatomical plate (PHLAP).
Consecutive 43 patients (22 females and 21 males) who underwent PHLAP for the treatment of PHF between 2010 and 2016 were evaluated. AO classifications were used for the classification of fractures. Based on the biomechanical stability the-ory of Erhardt et al., the patients were divided into two groups as <60% and >60% according to the number of screws fixed to the humeral head for the determination of PSD. The patients were divided into two groups as PSD <60% (n=21) and PSD>60% (n=22) according to the number of screws fixed to the humeral head for the determination of PSD. Functional results were evaluated using the Constant-Murley shoulder score (CMS). Radiological evaluation was performed with collodiaphyseal angle (CDA), varus-valgus angulation, avascular necrosis (AVN), and arthrosis. The groups were compared in terms of demographic characteristics, functional results, radiological scores, and complications.
The mean age was 54.47±17.43 years and the mean follow-up time was 19.51±5.27 months. Although the CMS scores of patients with a PSD of over 60% were higher than those below 60%, the CMS score did not differ statistically. In groups, the mean CDA of the operated shoulder was significantly lower than that of the non-injured side (p=0.002). Eight patients had varus angulation, whereas two patients had humerus head AVN. No significant relationship was observed between PDS and functional scores, radiolog-ical results, and complications.
Functional results of PSD >60% are higher than PSD <60% group but there is no statistical difference between groups according to functional, radiological results, and complications.
本研究旨在评估使用肱骨近端锁定解剖板（PHLAP）治疗肱骨近端骨折（PHF）时，钢板螺钉密度（PSD）与功能结果和并发症发生率之间的关系。
连续纳入 2010 年至 2016 年期间接受 PHLAP 治疗 PHF 的 43 例患者（女性 22 例，男性 21 例）。骨折采用 AO 分型。根据 Erhardt 等人的生物力学稳定性理论，根据固定于肱骨头的螺钉数量将患者分为<60%和>60%两组以确定 PSD。根据固定于肱骨头的螺钉数量将患者分为 PSD<60%（n=21）和 PSD>60%（n=22）两组以确定 PSD。采用 Constant-Murley 肩关节评分（CMS）评估功能结果。采用 collodiaphyseal 角（CDA）、内翻-外翻角度、缺血性坏死（AVN）和关节炎评估影像学结果。比较两组患者的一般特征、功能结果、影像学评分和并发症。
患者平均年龄为 54.47±17.43 岁，平均随访时间为 19.51±5.27 个月。尽管 PSD 超过 60%的患者 CMS 评分高于 PSD<60%的患者，但 CMS 评分无统计学差异。两组患者患侧 CDA 均值明显低于健侧（p=0.002）。8 例患者发生内翻畸形，2 例患者发生肱骨头 AVN。PSD 与功能评分、影像学结果和并发症之间未观察到显著相关性。
PSD>60%的功能结果高于 PSD<60%组，但两组在功能、影像学结果和并发症方面无统计学差异。
