Minimally invasive plate osteosynthesis with PHILOS plate for proximal humerus fractures.
Minimally invasive plate osteosynthesis with PHILOS plate for proximal humerus fractures.
复制标题
DOI：
10.1016/j.aott.2016.10.003
复制
发表时间：
2017-01
影响因子：
1
通讯作者：
Tanrıöver A
中科院分区：
文献类型：
--
作者：
Gönç U;Atabek M;Teker K;Tanrıöver A
本研究的目的是评估使用PHILOS®肱骨近端内锁定系统（Synthes Holding AG, Solothurn, Switzerland）对肱骨近端骨折进行微创钢板内固定（MIPO）治疗的结果，包括临床和影像学结果以及并发症数量。回顾性分析31例MIPO患者（男性12例，女性19例，平均年龄58.4岁）。根据Neer分类，2部分骨折4例，3部分骨折14例，4部分骨折13例。影像学评估愈合、并发症和头-轴角（HSA）。随访1年，采用恒评分法评估临床结果。骨折和正常肩部的平均Constant评分分别为73.2±10.9和84.8±5.1。内翻进展、骨折类型和年龄对功能结局无显著影响。术后和随访平均HSA分别为130.80±7.70和128.80±10.00。随访期间内翻进展明显（p = 0.01）。术后HSA < 130°的患者内翻进展更为明显（p < 0.001）。内侧跟骨螺钉的使用、骨折类型和年龄对内翻进展无显著影响。并发症包括种植体失败2例，缺血性坏死（AVN） 1例，原发性螺钉切断1例，腋窝神经损伤1例，桡神经损伤1例（22.6%）。MIPO是治疗肱骨近端骨折的一种安全有效的选择，具有良好的功能恢复和较少的并发症，通常依赖于技术。复位可能很困难，导致内翻进展。另一个缺点是有腋窝神经损伤的风险。谨慎的手术技术和正确的种植体选择是预防神经损伤的重要因素。四级，治疗性研究。
The aim of the present study was to evaluate results, including clinical and radiological outcomes and number of complications, following minimally invasive plate osteosynthesis (MIPO) of proximal humerus fractures, using the PHILOS® proximal humerus internal locking system (Synthes Holding AG, Solothurn, Switzerland). Retrospectively evaluated were 31 patients treated with MIPO (12 male, 19 female; average age: 58.4 years). Four patients had 2-part fractures, 14 patients had 3-part fractures, and 13 patients had 4-part fractures, according to Neer classification. Healing, complications, and head-shaft angle (HSA) were radiographically evaluated. Clinical outcomes were assessed at 1-year follow-up with Constant score. Average Constant scores for fractured and normal shoulders were 73.2 ± 10.9 and 84.8 ± 5.1, respectively. Varus progression, fracture type, and age had no significant effect on functional outcome. Average postoperative and follow-up HSA's were 130.80 ± 7.70 and 128.80 ± 10.00, respectively. Significant varus progression was observed during follow-up (p = 0.01). Varus progression was more prominent in patients with postoperative HSA < 130° (p < 0.001). Inferomedial calcar screw usage, fracture type, and age had no significant effect on varus progression. Complications included 2 implant failures, 1 case of avascular necrosis (AVN), 1 primary screw cut-out, 1 axillary nerve injury, and 1 radial nerve injury (22.6% overall). MIPO is a safe and effective option for the treatment of proximal humerus fractures, with good functional recovery and fewer complications, which are typically technique dependent. Reduction may be difficult, resulting in varus progression. Another disadvantage is risk of axillary nerve injury. Careful surgical technique and correct implant selection is important in the prevention of nerve injury. Level IV, Therapeutic study.
登录
查看更多内容
DOI：
10.1097/01.blo.0000152872.95806.09
发表时间：
2005-05-01
影响因子：
4.2
作者：
Gardner, MJ;Griffith, MH;Lorich, DG
通讯作者：
Lorich, DG
影响因子：
2.5
作者：
Park, Jin;Jeong, Seong Yup
通讯作者：
Jeong, Seong Yup
影响因子：
2.7
作者：
Falez, Francesco;Papalia, Matteo;Necozione, Stefano
通讯作者：
Necozione, Stefano
影响因子：
2.3
作者：
Gardner, Michael J.;Weil, Yoram;Lorich, Dean G.
通讯作者：
Lorich, Dean G.
影响因子：
1.6
作者：
Koljonen, Paul Aarne;Fang, Christian;Cheung, Nigel W. K.
通讯作者：
Cheung, Nigel W. K.