Comparative study between locking plates versus proximal humeral nail for the treatment of 2-part proximal humeral fractures
Comparative study between locking plates versus proximal humeral nail for the treatment of 2-part proximal humeral fractures
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DOI：
10.1007/s00590-011-0852-4
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发表时间：
2012-07-01
影响因子：
1.7
通讯作者：
Prat, Salvi
中科院分区：
文献类型：
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作者：
Domingo Trepat, Anna;Popescu, Dragos;Prat, Salvi
本研究的目的是比较Philos钢板和NHP-T2钉治疗移位的两部分肱骨近端骨折的功能和放射学效果。自2005年5月至2006年6月，我们共手术治疗了29例二分性肱骨骨折。植入物的选择不是随机的，但这是外科医生的选择。其中NHP-T2钉15例(A组)，Philos钢板14例(B组)。两组患者的平均年龄、性别分布、活动水平、损伤机制、骨折类型、合并骨折、红细胞压积均无统计学差异。术后数月对患者进行临床和放射学评估。在1年的随访中，一位独立评估者另外确定了常量和牛津分数。除1例骨折外，其余骨折均在前3个月内愈合。A组有1例延迟愈合，术后4个月愈合。两组各有2例畸形愈合。无1例观察到肱骨头缺血性坏死。两种植入物的功能结果之间没有统计学差异。B组需要输血的患者较多，A组有较多的入口处骨折和植入物取出，两组的巩固率和功能结果相似，无统计学意义。并发症似乎与手术方式有关，并不影响最终结果。要获得正确的复位和固定，需要准确的技术和足够的经验。
The aim of this study is to compare the functional and radiological results of Philos plate and NHP-T2 nail for the treatment of displaced 2-part proximal humeral fractures. Between May 2005 and June 2006, we operated 29 2-part humeral fractures. The selection of the implant was not randomized, but it was surgeon choice. There were 15 patients operated with the NHP-T2 nail (group A) and 14 patients with the Philos plate (group B). There were no statistical differences between the preoperative data of the two groups: mean age, sex distribution, level of activity, mechanism of injury, type of fracture, associated fractures, or the hematocrit levels. The patients were assed clinically and radiologically months after surgery. At 1-year follow-up, an independent evaluator additionally determined the Constant and Oxford scores. All fractures except one healed in the first 3 months. In group A, there was one delayed union that healed at 4 months. There were 2 malunion cases in each group. No case of avascular necrosis of the humeral head was observed. There were no statistical differences between the functional results of the implants. We had more patients who required blood transfusion in group B and more fractures of the entry point and implant removal in the group A. The consolidation rate and functional results are similar in both groups, with no statistical significance. The complications appeared seemed to be approach related and did not influence the final results. An accurate technique and sufficient experience are needed to achieve a correct reduction and fixation.