J Christoph Katthagen, O Lutz, C Voigt, H Lill, A Ellwein
{"title":"肱骨头螺钉水泥增强可减少肱骨近端骨折锁定钢板后早期植入物相关并发症。","authors":"J Christoph Katthagen, O Lutz, C Voigt, H Lill, A Ellwein","doi":"10.1007/s11678-018-0440-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cement augmentation (CA) of humeral head screws in locked plating of proximal humeral fractures (PHF) was found to be biomechanically beneficial. However, clinical outcomes of this treatment have not been well evaluated to date.</p><p><strong>Objectives: </strong>To assess outcomes of locked plating of PHF with additional CA and to compare them with outcomes of conventional locked plating without CA.</p><p><strong>Methods: </strong>24 patients (mean age, 74.2 ± 10.1 years; 22 female) with displaced PHF were prospectively enrolled and treated with locked plating and additional CA. The Constant score (CS), the Simple Shoulder Test (SST), and the Simple Shoulder Value (SSV) were assessed 3 and 12 months postoperatively. Fracture healing and potential complications were evaluated on postoperative radiographs. The CS and complications were compared with the outcomes of a matched group of 24 patients (mean age, 73.9 ± 9.4 years; 22 female) with locked plating of displaced PHF without CA.</p><p><strong>Results: </strong>At the 3‑month follow-up, the mean CS was 59.9 ± 15.6 points, the mean SST was 7.5 ± 2.7 points, and the mean SSV was 63.9 ± 21.7%. All scores significantly improved by the 12-month follow-up (<i>p</i> < 0.05; CS, 72.9 ± 17.7; SST, 9.2 ± 3.2; SSV, 77.2 ± 17.3%). There were two cases (8%) of biological complications (<i>n</i> = 1 varus malunion and <i>n</i> = 1 humeral head necrosis). Compared with locked plating without CA, no significant differences were observed between the CS at the 3‑ (57.8 ± 13.4 points; <i>p</i> = 0.62) and 12-month (73.0 ± 12.8 points; <i>p</i> = 0.99) follow-up. However, patients without CA had a significantly increased risk of early loss of reduction and articular screw perforation (<i>p</i> = 0.037).</p><p><strong>Conclusion: </strong>Locked plating of proximal humeral fractures with trauma cement augmentation of humeral head screws could be translated from the ex-vivo lab setting into the clinical situation without additional complications. Locked plating of displaced PHF with additional cement augmentation showed similar clinical outcomes but reduced the rate of early implant-related complications compared to locked plating without additional CA.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 2","pages":"123-129"},"PeriodicalIF":0.5000,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0440-x","citationCount":"33","resultStr":"{\"title\":\"Cement augmentation of humeral head screws reduces early implant-related complications after locked plating of proximal humeral fractures.\",\"authors\":\"J Christoph Katthagen, O Lutz, C Voigt, H Lill, A Ellwein\",\"doi\":\"10.1007/s11678-018-0440-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cement augmentation (CA) of humeral head screws in locked plating of proximal humeral fractures (PHF) was found to be biomechanically beneficial. However, clinical outcomes of this treatment have not been well evaluated to date.</p><p><strong>Objectives: </strong>To assess outcomes of locked plating of PHF with additional CA and to compare them with outcomes of conventional locked plating without CA.</p><p><strong>Methods: </strong>24 patients (mean age, 74.2 ± 10.1 years; 22 female) with displaced PHF were prospectively enrolled and treated with locked plating and additional CA. The Constant score (CS), the Simple Shoulder Test (SST), and the Simple Shoulder Value (SSV) were assessed 3 and 12 months postoperatively. Fracture healing and potential complications were evaluated on postoperative radiographs. The CS and complications were compared with the outcomes of a matched group of 24 patients (mean age, 73.9 ± 9.4 years; 22 female) with locked plating of displaced PHF without CA.</p><p><strong>Results: </strong>At the 3‑month follow-up, the mean CS was 59.9 ± 15.6 points, the mean SST was 7.5 ± 2.7 points, and the mean SSV was 63.9 ± 21.7%. All scores significantly improved by the 12-month follow-up (<i>p</i> < 0.05; CS, 72.9 ± 17.7; SST, 9.2 ± 3.2; SSV, 77.2 ± 17.3%). There were two cases (8%) of biological complications (<i>n</i> = 1 varus malunion and <i>n</i> = 1 humeral head necrosis). Compared with locked plating without CA, no significant differences were observed between the CS at the 3‑ (57.8 ± 13.4 points; <i>p</i> = 0.62) and 12-month (73.0 ± 12.8 points; <i>p</i> = 0.99) follow-up. However, patients without CA had a significantly increased risk of early loss of reduction and articular screw perforation (<i>p</i> = 0.037).</p><p><strong>Conclusion: </strong>Locked plating of proximal humeral fractures with trauma cement augmentation of humeral head screws could be translated from the ex-vivo lab setting into the clinical situation without additional complications. Locked plating of displaced PHF with additional cement augmentation showed similar clinical outcomes but reduced the rate of early implant-related complications compared to locked plating without additional CA.</p>\",\"PeriodicalId\":43682,\"journal\":{\"name\":\"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand\",\"volume\":\"13 2\",\"pages\":\"123-129\"},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2018-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1007/s11678-018-0440-x\",\"citationCount\":\"33\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s11678-018-0440-x\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2018/1/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s11678-018-0440-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/1/30 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Cement augmentation of humeral head screws reduces early implant-related complications after locked plating of proximal humeral fractures.
Background: Cement augmentation (CA) of humeral head screws in locked plating of proximal humeral fractures (PHF) was found to be biomechanically beneficial. However, clinical outcomes of this treatment have not been well evaluated to date.
Objectives: To assess outcomes of locked plating of PHF with additional CA and to compare them with outcomes of conventional locked plating without CA.
Methods: 24 patients (mean age, 74.2 ± 10.1 years; 22 female) with displaced PHF were prospectively enrolled and treated with locked plating and additional CA. The Constant score (CS), the Simple Shoulder Test (SST), and the Simple Shoulder Value (SSV) were assessed 3 and 12 months postoperatively. Fracture healing and potential complications were evaluated on postoperative radiographs. The CS and complications were compared with the outcomes of a matched group of 24 patients (mean age, 73.9 ± 9.4 years; 22 female) with locked plating of displaced PHF without CA.
Results: At the 3‑month follow-up, the mean CS was 59.9 ± 15.6 points, the mean SST was 7.5 ± 2.7 points, and the mean SSV was 63.9 ± 21.7%. All scores significantly improved by the 12-month follow-up (p < 0.05; CS, 72.9 ± 17.7; SST, 9.2 ± 3.2; SSV, 77.2 ± 17.3%). There were two cases (8%) of biological complications (n = 1 varus malunion and n = 1 humeral head necrosis). Compared with locked plating without CA, no significant differences were observed between the CS at the 3‑ (57.8 ± 13.4 points; p = 0.62) and 12-month (73.0 ± 12.8 points; p = 0.99) follow-up. However, patients without CA had a significantly increased risk of early loss of reduction and articular screw perforation (p = 0.037).
Conclusion: Locked plating of proximal humeral fractures with trauma cement augmentation of humeral head screws could be translated from the ex-vivo lab setting into the clinical situation without additional complications. Locked plating of displaced PHF with additional cement augmentation showed similar clinical outcomes but reduced the rate of early implant-related complications compared to locked plating without additional CA.
期刊介绍：
Zielsetzung der Zeitschrift
Die Zeitschrift Obere Extremität widmet sich der Versorgung von Verletzungen, Verletzungsfolgen und Erkrankungen im Bereich des Schulter- und des Ellenbogengelenks.
Frei eingereichte Originalien präsentieren Forschungsergebnisse aktueller Studien im Bereich der Schulter- und Ellenbogenchirurgie und fördern den wissenschaftlichen Austausch. Vielversprechende Studien, die derzeit durchgeführt werden, sind ebenso willkommen, wie Langzeitstudien, die bewährte Verfahren auf den Prüfstand stellen. Fallberichte beleuchten seltene Indikationen und schildern ungewöhnliche Behandlungsverläufe.
Umfassende Übersichtsarbeiten zu einem aktuellen Schwerpunktthema sind das Kernstück jeder Ausgabe. Im Mittelpunkt steht gesichertes Wissen mit hoher Relevanz für die tägliche Arbeit in der Schulter- und Ellenbogenchirurgie. Zusätzlich wird in speziellen Rubriken über innovative Behandlungsmaßnahmen, Probleme in der Begutachtung, berufspolitische Entwicklungen und Kongressaktivitäten berichtet.
Als gemeinsames Kommunikations- und Weiterbildungsforum für alle Chirurg*innen und Orthopäd*innen mit entsprechender Spezialisierung ist die Zeitschrift Obere Extremität zukunftsorientiert und schließt eine wichtige Lücke im orthopädisch-unfallchirurgischen Informationsangebot.
Aims & scope
The journal Obere Extremität (Upper Extremity) is dedicated to the treatment of injuries, consequences of injuries and diseases in the area of the shoulder and elbow joint.
Freely submitted originals present research results of current studies in the field of shoulder and elbow surgery and promote scientific exchange. Promising studies that are currently being carried out are welcome, as are long-term studies that put proven procedures to the test. Case reports illuminate rare indications and describe unusual courses of treatment.
Comprehensive reviews on a current focus topic are the core of each issue. The focus is on secured knowledge with high relevance for the daily work in shoulder and elbow surgery. In addition, special sections report on innovative treatment measures, problems in assessment, professional policy developments and congress activities.
As a joint communication and further education forum for all surgeons and orthopaedic surgeons with appropriate specialisation, the journal Obere Extremität is future-oriented and closes an important gap in the orthopaedic trauma surgery information offer.
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All manuscripts submitted to the journal Obere Extremität (including invited manuscripts) undergo a double-blind peer review process involving at least two independent experts.
Ethische Richtlinien / Best Practice Guidelines and Publication Ethics
Die Zeitschrift Obere Extremität folgt den Richtlinien des Komitees für Publikationsethik (COPE). Autoren wird empfohlen, klinische Studien, die sie zur Veröffentlichung in Betracht ziehen, vor der Veröffentlichung in kostenlosen, öffentlichen Registern für klinische Studien (z.B. www.clinicaltrials.gov, http://clinicaltrials.ifpma.org, http://isrctn.org, www.germanctr.de/online-Register_de.html) zu registrieren. Die Register sind nach den Richtlinien des International Committee of Medical Journal Editors (ICMJE) zu genehmigen. Die Autor*innen sollten am Ende ihres Abstracts den Namen des Studienregisters und ihre Registriernummer für klinische Studien angeben.
The journal Obere Extremität (Upper Extremity) follows the Committee of Publications Ethics (COPE) - Guidelines. Authors are recommended to register clinical trials they consider for publication in free, public clinical trial registries (e.g., www.clinicaltrials.gov, http://clinicaltrials.ifpma.org, http://isrctn.org, www.germanctr.de/online-Register_de.html) before publication. The registries are to be approved by the guidelines of the International Committee of Medical Journal Editors (ICMJE). Authors should include the name of the trial register and their clinical trial registration number at the end of their abstract.
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Alle zur Veröffentlichung eingereichten Manuskripte, die Ergebnisse von Studien an Proband*innen oder Patient*innen präsentieren, müssen gemäß den Autorenrichtlinien für Originalarbeiten der Deklaration von Helsinki entsprechen.
All Manuscripts submitted for publication presenting results from studies on probands or patients must comply with the Declaration of Helsinki according to the author guidelines for original papers.
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