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使用带有光滑钉的肱骨近端接骨板系统对肱骨近端骨折进行切开复位内固定的结果

Results of open reduction and internal fixation of proximal humerus fractures using a proximal humeral plating system with smooth pegs.

作者信息

Kjaer Christoffer, Hillblom Magnus, Lenholm Emma, Boström Windhamre Helena, Ekelund Anders

机构信息

Department of Orthopaedic Surgery, Capio St Görans Hospital, Stockholm, Sweden.

Department of Radiology, Capio St Görans Hospital, Stockholm, Sweden.

出版信息

Shoulder Elbow. 2025 Jan 15:17585732241309582. doi: 10.1177/17585732241309582.

Abstract

BACKGROUND

The aim of this study was to evaluate clinical results and complication rate in patients with proximal humeral fracture treated with Anatomical Locking Plate System (A.L.P.S.) Proximal Humeral Plating System with smooth pegs.

METHODS

Retrospective evaluation of 116 consecutive patients treated with A.L.P.S. Proximal Humeral Plating System. Shoulder function was evaluated by Constant score and disabilities of arm, shoulder and hand (DASH). Furthermore, European Quality of life 5 Dimensions (EQ-5D) and single shoulder value (SSV) were assessed. Fractures were classified according to Neer.

RESULTS

Fifty-two patients were included with a mean follow-up of 49 months. Mean Constant score was 62.8. Mean DASH was 17, and the mean EQ-5D was 0.91. According to Neer classification 63% ( = 33) of the fractures were two-part, 31% ( = 16) three-part, and 6% ( = 3) four-part fractures. Peg penetration was registered in 13 cases (25%,  = 52). In total a reoperation rate of 23% ( = 12) and an overall complication rate of 37% ( = 19) were recorded.

DISCUSSION/CONCLUSION: Open reduction and plate fixation with the A.L.P.S. Proximal Humeral Plating System with smooth pegs provides a stable fixation with good clinical outcome and complication and reoperation rates in line with previous studies with plates using screws in the humeral head.

摘要

背景

本研究旨在评估采用带光滑栓钉的解剖锁定钢板系统(A.L.P.S.)近端肱骨接骨板系统治疗近端肱骨骨折患者的临床效果及并发症发生率。

方法

对116例连续接受A.L.P.S.近端肱骨接骨板系统治疗的患者进行回顾性评估。采用Constant评分以及手臂、肩部和手部功能障碍(DASH)评分评估肩部功能。此外,还评估了欧洲五维健康量表(EQ - 5D)和单肩值(SSV)。骨折按Neer分类法进行分类。

结果

纳入52例患者,平均随访49个月。Constant评分均值为62.8。DASH评分均值为17,EQ - 5D均值为0.91。根据Neer分类,63%(n = 33)的骨折为两部分骨折,31%(n = 16)为三部分骨折,6%(n = 3)为四部分骨折。13例(25%,n = 52)出现栓钉穿透。总共记录到再手术率为23%(n = 12),总体并发症发生率为37%(n = 19)。

讨论/结论:使用带光滑栓钉的A.L.P.S.近端肱骨接骨板系统进行切开复位钢板固定可提供稳定的固定,临床效果良好,并发症和再手术率与先前使用肱骨头螺钉钢板的研究结果一致。

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Early Results of the A.L.P.S. Proximal Humerus Locking Plate.A.L.P.S. 肱骨近端锁定钢板的早期结果
Open Orthop J. 2018 Feb 28;12:53-58. doi: 10.2174/1874325001812010053. eCollection 2018.
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Epidemiology of proximal humerus fractures.肱骨近端骨折的流行病学
Arch Osteoporos. 2015;10:209. doi: 10.1007/s11657-015-0209-4. Epub 2015 Feb 13.

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