Complications and Outcomes of Minimally Invasive Percutaneous Plating for Proximal Humeral Fractures
Complications and Outcomes of Minimally Invasive Percutaneous Plating for Proximal Humeral Fractures
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DOI：
10.4055/cios.2014.6.2.146
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发表时间：
2014-06-01
影响因子：
2.5
通讯作者：
Jeong, Seong Yup
中科院分区：
文献类型：
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作者：
Park, Jin;Jeong, Seong Yup
背景：采用关节周围锁定钢板的微创钢板内固定（MIPO）技术可能是肱骨近端移位骨折修复的一个很好的选择。然而，与该技术相关的腋窝神经并发症可能被低估。本研究的目的是评估微创钢板的疗效，重点是并发症。方法：回顾性分析21例连续应用锁定钢板MIPO技术治疗肱骨近端骨折的临床资料。这些患者在2009年3月至2011年3月期间接受治疗，随访时间至少为一年。评估临床功能、并发症及影像学骨愈合情况。结果：除1例患者外，所有患者术后6个月肩关节屈曲外展至少90度。随访3个月、6个月和1年的平均Constant得分分别为74.0（范围62至90）、79.4（范围64至91）和82.7（范围66至92）。所有患者均在平均3.2个月（2 ~ 6个月）内实现骨愈合。1例延迟愈合，1例关节内螺钉插入，1例腋窝神经麻痹（不完全性损伤），随访1年未完全恢复。结论：关节周围锁定钢板的MIPO技术是治疗肱骨近端移位骨折的有效选择。然而，在选择微创电镀患者时，应考虑神经并发症，如腋窝神经麻痹和种植体相关并发症。
Background: The minimally invasive plate osteosynthesis (MIPO) technique using periarticular locking plates may be a good option for the repair of displaced proximal humeral fractures. However, axillary nerve complications related to this technique may be underestimated. The purpose of this study is to evaluate the outcomes of the minimally invasive plating, focusing on the complications.Methods: The records of 21 consecutive patients treated for proximal humerus fractures using the MIPO technique with locking plates were retrospectively reviewed. These patients were treated between March 2009 and March 2011 with a minimum oneyear follow-up. The clinical function, complications, and radiological bony union were evaluated.Results: All of the patients, with one exception, showed at least 90 degrees of flexion and abduction at the shoulder joint six months postoperatively. The average Constant scores at three months, six months, and one year follow-ups were 74.0 (range, 62 to 90), 79.4 (range, 64 to 91), and 82.7 (range, 66 to 92), respectively. All of the patients achieved bony union within the average of 3.2 months (range, 2 to 6 months). There was one case of delayed union, one case of intra-articular screw penetration, and one case of axillary nerve paresis (incomplete injury), which did not completely recover during the one year of follow-up.Conclusions: The MIPO technique using periarticular locking plates is a useful option for the treatment of selected cases of displaced proximal humeral fractures. However, nerve complications such as axillary nerve paresis should be considered along with implant-related complications when choosing patients for minimally invasive plating.