Functional outcomes and complications after locked plating of fracture-dislocations of the proximal humerus and the significance of the intertuberosity periosteal bridge.

IF 1.1 Q3 ORTHOPEDICS
Dipit Sahu, Aditya Chaubey, Darshil Shah, Ashish Phadnis
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引用次数: 0

Abstract

Background: We aimed to evaluate the functional outcomes and complications following locked plating of three- or four-part proximal humerus fracture-dislocations (PHFDs).

Methods: We evaluated the functional outcomes and range of motion (ROM) deficit of 26 shoulders with PHFD (AO/OTA 11B1.1(5a), 11B1.1(5b), 11B1.2(5b), 11C3.1(5a), 11C3.1(5b), 11C3.2(5a)), in 25 patients after locking plate fixation. Three patients with avascular necrosis (AVN) of humeral head were followed for one year, and the remaining 22 patients were followed for 24-89 months.

Results: At the most recent follow-up, the shoulder subjective value was 77 (60-85), the normalized Constant score was 70 (53-83), the visual analogue scale pain scores were 1 (0-2), the elevation ROM deficit was 35° (13-41), the external rotation ROM deficit was 20° (10-33), and internal rotation ROM (number of vertebrae) deficit was 4 (1-6). AVN was noted in six (23%) shoulders; the shoulders with AVN had worse outcomes than those without AVN. Absent capsular attachments (p < .001), an opened intertuberosity periosteum, and a four-part fracture configuration (p = .004) were significantly associated with AVN.

Conclusion: To conclude, functional outcomes after locked plating of fracture-dislocations were acceptable in the majority of the patients. However, complications such as AVN may occur in 23% of patients, leading to poor outcomes.

Level of evidence: Level 4; case series.

肱骨近端骨折脱位锁定钢板后的功能结局及并发症及结节间骨膜桥的意义。
背景:我们旨在评估肱骨近端三段或四段骨折脱位(phfd)锁定钢板后的功能结局和并发症。方法:我们评估了25例锁定钢板固定后26例肩部PHFD (AO/OTA 11B1.1(5a)、11B1.1(5b)、11B1.2(5b)、11C3.1(5a)、11C3.1(5b)、11C3.2(5a))患者的功能结局和活动范围(ROM)缺损。3例肱骨头缺血性坏死(AVN)患者随访1年,其余22例随访24-89个月。结果:在最近的随访中,肩部主观值为77(60-85),标准化常数评分为70(53-83),视觉模拟量表疼痛评分为1(0-2),上抬ROM缺损为35°(13-41),外旋ROM缺损为20°(10-33),内旋ROM(椎骨数)缺损为4(1-6)。6例(23%)肩出现AVN;有AVN的肩部比没有AVN的肩部预后更差。无包膜附着体(p p = 0.004)与AVN显著相关。结论:总的来说,大多数患者骨折脱位锁定钢板后的功能结果是可以接受的。然而,23%的患者可能出现AVN等并发症,导致预后不佳。证据等级:4级;系列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Shoulder and Elbow
Shoulder and Elbow Medicine-Rehabilitation
CiteScore
2.80
自引率
0.00%
发文量
91
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