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Abstract：
BACKGROUND: The treatment of the displaced proximal humerus fractures (PHF) still facing a lot of unsolved problems. The aim of this study was to evaluate the clinical effect of MultiLoc nails for the treatment of PHF and present outcomes of patients with different Neer\'s classification and reduction quality.
METHODS: Adult patients with PHFs were recruited and treated with MultiLoc nail. Intraoperative data, radiographic and functional outcomes, as well as occurrence of postoperative complications were assessed.
RESULTS: 48 patients met inclusion and exclusion criteria and were included in this study. The DASH Score were 32.2 ± 3.1 points at 12 months, and 37.3 ± 2.5 points at the final follow-up. The mean ASES score at 12 months and final follow-up were 74.4 ± 6.2 and 78.8 ± 5.1, respectively. The mean CM Score in all 48 patients reached 68 ± 6.4 points at the final follow-up, relative side related CM Score 75.2 ± 7.7% of contralateral extremity. The incidence rate of complications was 20.8%. Patients with fracture mal-union, adhesive capsulitis were observed but no secondary surgeries were performed. There was no significantly difference of DASH Score 12 months after surgery and at the last follow-up among patients with different Neer\'s classification or reduction quality. However, functional outcomes such as ASES score and CM score were significantly influenced by severity of fracture and the quality of fracture reduction.
CONCLUSIONS: Our study demonstrated that MultiLoc nails is well suited for proximal humeral fractures, with satisfactory health status recovery, good radiographic results, positive clinical outcomes and low rates of complications. The treatment for four part PHF still faces great challenges. Accurate fracture reduction was an important factor for good functional result.
METHODS: Adult patients with PHFs were recruited and treated with MultiLoc nail. Intraoperative data, radiographic and functional outcomes, as well as occurrence of postoperative complications were assessed.
RESULTS: 48 patients met inclusion and exclusion criteria and were included in this study. The DASH Score were 32.2 ± 3.1 points at 12 months, and 37.3 ± 2.5 points at the final follow-up. The mean ASES score at 12 months and final follow-up were 74.4 ± 6.2 and 78.8 ± 5.1, respectively. The mean CM Score in all 48 patients reached 68 ± 6.4 points at the final follow-up, relative side related CM Score 75.2 ± 7.7% of contralateral extremity. The incidence rate of complications was 20.8%. Patients with fracture mal-union, adhesive capsulitis were observed but no secondary surgeries were performed. There was no significantly difference of DASH Score 12 months after surgery and at the last follow-up among patients with different Neer\'s classification or reduction quality. However, functional outcomes such as ASES score and CM score were significantly influenced by severity of fracture and the quality of fracture reduction.
CONCLUSIONS: Our study demonstrated that MultiLoc nails is well suited for proximal humeral fractures, with satisfactory health status recovery, good radiographic results, positive clinical outcomes and low rates of complications. The treatment for four part PHF still faces great challenges. Accurate fracture reduction was an important factor for good functional result.
摘要：
背景：移位的肱骨近端骨折（PHF）的治疗仍面临许多未解决的问题。这项研究的目的是评估MultiLoc指甲治疗PHF的临床效果，并介绍具有不同Neer分类和复位质量的患者的预后。
方法：招募患有PHF的成年患者，并接受MultiLoc指甲治疗。术中数据,放射学和功能结果，以及术后并发症的发生情况进行评估。
结果：48例患者符合纳入和排除标准，被纳入本研究。12个月时DASH评分为32.2±3.1分,最后随访时37.3±2.5分。12个月和最终随访时的平均ASES评分分别为74.4±6.2和78.8±5.1。在最后一次随访时，所有48例患者的平均CM评分达到68±6.4分，对侧肢体的相对侧相关CM评分75.2±7.7％。并发症发生率为20.8%。骨折愈合不良的患者，观察到粘连性囊炎,但未进行二次手术.术后12个月和末次随访时,不同Neer分类或复位质量的患者DASH评分差异无统计学意义。然而,ASES评分和CM评分等功能结局受骨折严重程度和骨折复位质量显著影响.
结论：我们的研究表明MultiLoc钉非常适合肱骨近端骨折，健康状况恢复令人满意，良好的射线照相结果，积极的临床结果和低的并发症发生率。四部分PHF的治疗仍面临巨大挑战。准确的骨折复位是良好功能结果的重要因素。
方法：招募患有PHF的成年患者，并接受MultiLoc指甲治疗。术中数据,放射学和功能结果，以及术后并发症的发生情况进行评估。
结果：48例患者符合纳入和排除标准，被纳入本研究。12个月时DASH评分为32.2±3.1分,最后随访时37.3±2.5分。12个月和最终随访时的平均ASES评分分别为74.4±6.2和78.8±5.1。在最后一次随访时，所有48例患者的平均CM评分达到68±6.4分，对侧肢体的相对侧相关CM评分75.2±7.7％。并发症发生率为20.8%。骨折愈合不良的患者，观察到粘连性囊炎,但未进行二次手术.术后12个月和末次随访时,不同Neer分类或复位质量的患者DASH评分差异无统计学意义。然而,ASES评分和CM评分等功能结局受骨折严重程度和骨折复位质量显著影响.
结论：我们的研究表明MultiLoc钉非常适合肱骨近端骨折，健康状况恢复令人满意，良好的射线照相结果，积极的临床结果和低的并发症发生率。四部分PHF的治疗仍面临巨大挑战。准确的骨折复位是良好功能结果的重要因素。
