Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Republic of Korea.
J Orthop Trauma. 2023 Oct 1;37(10):e387-e393. doi: 10.1097/BOT.0000000000002645.
To compare radiological and clinical outcomes between lateral locking plate (LLP) and dual-plate fixation (LLP and additional medial buttress plate) for proximal humerus fractures with medial column comminution and varus deformity in patients with osteoporosis.
Retrospective.
Academic medical center.
PATIENTS/PARTICIPANTS: Overall, 52 patients were enrolled. Of these, 26 patients underwent dual-plate fixation. The control group (LLP) was matched to the dual-plate group for age, sex, injured side, and fracture type.
Patients in the dual-plate group were treated with LLP and medial buttress plate, whereas patients in the LLP group were treated with only an LLP.
Demographic factors, operative time, and level of hemoglobin of the 2 groups obtained from medical records. Changes in the neck-shaft angle and the development of postoperative complications were recorded. Clinical outcomes were measured based on the visual analog scale; American Shoulder and Elbow Surgeons; Disabilities of the Arm, Shoulder, and Hand; and Constant-Murley scores.
The operation time and hemoglobin loss did not differ significantly between the groups. Radiographic evaluation showed a significantly lower change in neck-shaft angle in the dual-=plate group than in the LLP group. The dual-plate group also showed better Disabilities of the Arm, Shoulder, and Hand; American Shoulder and Elbow Surgeons; and Constant-Murley scores than the LLP group.
Fixation using additional medial buttress plate with LLP may be considered for treating proximal humerus fractures in patients with an unstable medial column, varus deformity, and osteoporosis.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
比较骨质疏松症伴内侧柱粉碎和内翻畸形的肱骨近端骨折患者中，外侧锁定钢板（LLP）与双钢板固定（LLP 和附加内侧支撑钢板）的影像学和临床结果。
回顾性研究。
学术医疗中心。
患者/参与者：共有 52 名患者入组。其中 26 名患者接受了双钢板固定。对照组（LLP）与双钢板组在年龄、性别、受伤侧和骨折类型方面相匹配。
双钢板组患者采用 LLP 和内侧支撑钢板治疗，而 LLP 组患者仅采用 LLP 治疗。
从病历中获取 2 组患者的人口统计学因素、手术时间和血红蛋白水平。记录颈干角的变化和术后并发症的发生情况。根据视觉模拟评分、美国肩肘外科医师协会评分、上肢残疾评分和Constant-Murley 评分来评估临床结果。
2 组的手术时间和血红蛋白丢失无显著差异。影像学评估显示，双钢板组的颈干角变化明显低于 LLP 组。双钢板组的上肢残疾评分、美国肩肘外科医师协会评分和 Constant-Murley 评分也明显优于 LLP 组。
对于不稳定内侧柱、内翻畸形和骨质疏松症的肱骨近端骨折患者，采用 LLP 附加内侧支撑钢板固定可能是一种可行的治疗选择。
治疗性 III 级。请参见作者说明，以获取完整的证据水平描述。
