Descalzo Godoy Ignacio, Velasco Alcalde Paula, Del Olmo Galeano Alberto, Del Río Hortelano Julián, Martínez Velez David, Fernández González Julián
Department of Orthopaedic Surgery and Traumatology, University Hospital La Princesa, Universidad Autónoma de Madrid, C/Diego de León 62, 28006, Madrid, Spain.
Eur J Orthop Surg Traumatol. 2024 Jan;34(1):415-423. doi: 10.1007/s00590-023-03675-y. Epub 2023 Aug 11.
Verify if the use of locking plates in displaced three- and four-part proximal humerus fractures has meant an improvement even in patients over 70 years of age.
We performed surgery with locking plate fixation in 56 consecutive patients with three- and four-part proximal humerus fractures according to Neer's classification between 1/1/15 and 12/31/20 at our Hospital. Patient satisfaction, quality of life, functionality and radiological variables, as well as the comparison between patients older and younger than 70 years were the main outcomes. Likewise, factors and complications that may have influenced these variables were analyzed as secondary outcomes. The analysis of all these variables was performed after a minimum follow-up time of 24 months after surgery.
51 patients (92%) ended up satisfied or very satisfied according to the SF-36 test and with no disability or mild disability according to the DASH Score questionnaire. 46 patients (82%) obtained a satisfactory or excellent result according to the Neer scale modified by Cofield and 38 (68%) a good or excellent function according to the Constant Murley questionnaire. In 47 cases (84%) good radiological alignment was observed. Complications occurred in 20 patients (36%). The complications and the results of the SF-36, DASH Score, Neer scale modified by Cofield and Constant Murley tests depended on the radiological alignment (p = 0.009, p = 0.006, p = 0.025, p = 0.0008 and p = 0.0004). There were 37 patients younger than 70 years and 19 older than 70 years with no statistically significant differences when comparing the two groups.
This study demonstrates that satisfactory results can be obtained with osteosynthesis with locking plates in displaced proximal humerus fractures even in patients older than 70 years of age.
Retrospective Cohort, Treatment Study.
验证锁定钢板用于治疗移位的三部分和四部分近端肱骨骨折，是否即使在70岁以上的患者中也意味着治疗效果有所改善。
2015年1月1日至2020年12月31日期间，我们在我院对56例根据Neer分类法诊断为三部分和四部分近端肱骨骨折的患者，连续进行了锁定钢板固定手术。主要观察指标包括患者满意度、生活质量、功能和影像学变量，以及70岁及以上患者与70岁以下患者之间的比较。同样，将可能影响这些变量的因素和并发症作为次要观察指标进行分析。所有这些变量的分析均在术后至少24个月的随访时间后进行。
根据SF-36测试，51例患者（92%）最终表示满意或非常满意，根据DASH评分问卷，无残疾或轻度残疾。根据Cofield修改的Neer量表，46例患者（82%）获得了满意或优异的结果，根据Constant Murley问卷，38例患者（68%）获得了良好或优异的功能。47例患者（84%）观察到良好的影像学对线。20例患者（36%）出现并发症。SF-36、DASH评分、Cofield修改的Neer量表和Constant Murley测试的并发症及结果均取决于影像学对线情况（p = 0.009、p = 0.006、p = 0.025、p = 0.0008和p = 0.0（此处原文有误，推测为0.0004））。70岁以下患者37例，70岁以上患者19例，两组比较无统计学显著差异。
本研究表明，即使在70岁以上的患者中，采用锁定钢板进行切开复位内固定治疗移位的近端肱骨骨折，也能获得满意的结果。
证据级别III：回顾性队列研究，治疗性研究。
