Second generation locked plating of proximal humerus fractures-A prospective multicentre observational study
Second generation locked plating of proximal humerus fractures-A prospective multicentre observational study
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DOI：
10.1007/s00264-010-1015-7
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发表时间：
2011-03-01
影响因子：
2.7
通讯作者：
Gebhard, Florian
中科院分区：
文献类型：
--
作者：
Roederer, Goetz;Erhardt, Johannes;Gebhard, Florian
由于骨质疏松，大多数移位的肱骨近端骨折的手术治疗具有挑战性。锁定板旨在提供优越的机械稳定性。在一项前瞻性多中心研究中，131例患者接受了第二代锁定钢板治疗（NCB-PH, Zimmer, Inc.）。开放手术（n=78）采用三角胸肌入路；微创技术（n=53）包括经皮复位和前外侧三角肌切开入路。进行临床及影像学随访。功能（ROM）改善有统计学意义。骨折类型（AO）对并发症的发生率影响最大。最常见的并发症是关节内螺钉穿孔（15%）和继发性移位（8%）。NCB-PH的并发症发生率和功能结局与文献报道相当。并不是所有的问题都可以通过新一代的植入物得到解决，也就是说，8%的患者仍然会发生继发性脱位。
Surgical treatment of most displaced proximal humerus fractures is challenging due to osteoporosis. Locking plates are intended to provide superior mechanical stability. In a prospective multicentre study 131 patients were treated with second generation locked plating (NCB-PH, Zimmer, Inc.). The open procedure (n=78) was performed using a deltopectoral approach; the minimally invasive technique (n=53) involved percutaneous reduction and an anterolateral deltoid split approach. Clinical and radiological follow-up was obtained. Improvement in function (ROM) was statistically significant. Fracture type (AO) had the most significant impact on the incidence of complications. The most frequent complications detected were intra-articular screw perforation (15%) and secondary displacement (8%). Complication rate and functional outcome of the NCB-PH are comparable to reports in the literature. Not all problems are likely to be solved by this new generation of implants, i.e. secondary dislocation still occurred in 8% of our patients.