Samargandi Ramy, Albashri Jawad, Albashri Ahmed, Alzahrani Faris, Hassan Abdulrahman, Berhouet Julien
Department of Orthopedic Surgery, College of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia.
Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Régional Universitaire (CHRU) de Tours, 1C Avenue de la République, 37170 Chambray-les-Tours, France.
J Clin Med. 2024 Dec 4;13(23):7398. doi: 10.3390/jcm13237398.
There is no consensus in the literature regarding the optimal treatment for complex proximal humerus fractures (PHFs). The aim of this study is to evaluate the clinical, functional, and radiological outcomes, and complications, associated with the Bilboquet implant in the treatment of PHFs. The search was conducted from the first description of the Bilboquet device in 1994 to June 2024, across PubMed, Web of Science, and Google Scholar, using specific keywords such as ("Bilboquet" OR "Bilboquet prosthesis" OR "Bilboquet device") AND ("proximal humerus fracture" OR "shoulder fracture"), along with Boolean operators. The inclusion criteria comprised studies published in English or French that focused on the use of the Bilboquet implant for PHFs. Eligible study designs included case series, cohort studies, randomized controlled trials (RCTs), and non-RCTs evaluating clinical, functional, and radiological outcomes, and complications. Studies that do not contain relevant results to this systematic review, pediatric populations, or the use of alternative implants were excluded. A total of eight studies (235 patients) published between 1996 and 2021 were included. The mean age was 68.6 years (56 to 76.8) in all the studies. The majority of patients, 76.2%, were females, with male patients accounting for only 23.8%. A total of 10 (4.3%) patients had 2-part fractures, 40% of patients had 3-part fractures, and 55.7% of patients had 4-part fractures. The mean follow-up was 36.4 months (25.8-88.7), with a mean constant score of 69.7 (62-78.6). Complications included non-union in 2.65% of cases, avascular necrosis in 19.7%, revision surgery in 5.1%, and protrusion of the staple in 4.3%. Despite limited knowledge of the Bilboquet implant, it shows promise in managing complex PHFs in both young and older adults, with favorable clinical and radiological outcomes. It offers advantages over traditional fixation methods and allows easy conversion to arthroplasty if osteonecrosis occurs. However, the long-term outcomes require further study. While early results are promising, larger randomized studies are needed to confirm its broader clinical utility.
关于复杂肱骨近端骨折（PHF）的最佳治疗方法，文献中尚无共识。本研究的目的是评估Bilboquet植入物治疗PHF的临床、功能和放射学结果以及并发症。检索时间从1994年Bilboquet装置首次被描述至2024年6月，通过PubMed、科学网和谷歌学术，使用特定关键词，如（“Bilboquet”或“Bilboquet假体”或“Bilboquet装置”）以及（“肱骨近端骨折”或“肩部骨折”），并结合布尔运算符。纳入标准包括以英文或法文发表的、聚焦于Bilboquet植入物用于PHF的研究。符合条件的研究设计包括病例系列、队列研究、随机对照试验（RCT）以及评估临床、功能和放射学结果及并发症的非随机对照试验。不包含与本系统评价相关结果的研究、儿科人群研究或使用替代植入物的研究被排除。总共纳入了1996年至2021年间发表的8项研究（235例患者）。所有研究中患者的平均年龄为68.6岁（56至76.8岁）。大多数患者（76.2%）为女性，男性患者仅占23.8%。共有10例（4.3%）患者为二部分骨折，40%的患者为三部分骨折，55.7%的患者为四部分骨折。平均随访时间为36.4个月（25.8 - 88.7个月），平均Constant评分69.7（62 - 78.6）。并发症包括2.65%的病例出现骨不连，19.7%出现缺血性坏死，5.1%进行了翻修手术，4.3%出现钉突。尽管对Bilboquet植入物的了解有限，但它在治疗年轻和老年成人的复杂PHF方面显示出前景，具有良好的临床和放射学结果。它比传统固定方法具有优势，并且如果发生骨坏死，允许轻松转换为关节成形术。然而，长期结果需要进一步研究。虽然早期结果很有希望，但需要更大规模的随机研究来证实其更广泛的临床应用价值。
