Brooker-Thompson Chad, Mohan Hariharan, Chotai Neil, Baring Toby
Department of Orthopaedics, Homerton University Hospital, London, UK.
Shoulder Elbow. 2024 Oct;16(6):605-610. doi: 10.1177/17585732231184208. Epub 2023 Jun 26.
Conventional techniques for the fixation of displaced proximal humeral fractures include the use of locking plates, intramedullary nailing, hemiarthroplasty and reverse shoulder replacement. Valgus-impacted fractures are a common subtype of proximal humeral fracture, but there are few publications concerning the outcomes of treatment. This study aims to review outcomes following an 'all-suture' technique for this fracture subtype without the use of transosseous sutures.
All patients over the age of 18 who presented with 3- or 4-part valgus-impacted proximal humeral fractures and who underwent 'all-suture' repair at our centre were included. We reviewed their post-operative imaging and collected data on post-operative complications and patient-reported outcome measures.
We identified 15 patients who had undergone all-suture fixation. The cohort's mean age was 56. Eleven patients were female. Eight patients had 3-part fractures and seven patients had 4-part fractures. There were no major post-operative complications. All fractures united. The mean Oxford Shoulder Score was 43.7 and the mean Single Assessment Numerical Evaluation score was 85.9 at the final follow-up.
Our results suggest that all-suture fixation of proximal humeral fractures presents an attractive alternative to conventional techniques, whilst avoiding complications relating to metalwork implantation.
治疗移位的肱骨近端骨折的传统技术包括使用锁定钢板、髓内钉、半关节置换和反肩关节置换。外翻嵌插骨折是肱骨近端骨折的常见亚型，但关于其治疗结果的文献报道较少。本研究旨在回顾采用“全缝线”技术治疗该骨折亚型且不使用经骨缝线的治疗结果。
纳入所有18岁以上、出现三部分或四部分外翻嵌插肱骨近端骨折且在本中心接受“全缝线”修复的患者。我们回顾了他们的术后影像学资料，并收集了术后并发症及患者报告的结局指标数据。
我们确定了15例接受全缝线固定的患者。该队列的平均年龄为56岁。11例为女性。8例为三部分骨折，7例为四部分骨折。无重大术后并发症。所有骨折均愈合。末次随访时，牛津肩评分平均为43.7，单项评估数值评定评分平均为85.9。
我们的结果表明，肱骨近端骨折的全缝线固定是传统技术的一种有吸引力的替代方法，同时避免了与金属植入物相关的并发症。
