PDF(Pubmed)
Abstract：
BACKGROUND: Proximal humerus fractures are primarily common in the old age group. The appropriate approach to managing such displaced and comminuted fracture patterns is often questionable. Hence, this study was conducted to assess the functional outcome of proximal humerus fractures following treatment with a proximal humerus locking plate and to assess the frequency of complications in such patients.
METHODS: In this robust study, 33 cases of proximal humerus fractures underwent surgical management at a prestigious teaching hospital from February 2021 to August 2022 utilizing a proximal humerus internal locking system (PHILOS) plate. The NEER classification was employed to categorize the fractures, and the NEER score was used for functional assessment. It\'s crucial to note that individuals with pathological fractures, associated injuries in the ipsilateral limb, nerve injuries, and cases of open fracture were rigorously excluded from the study.
RESULTS: The mean age was 47 ± 5.2 years. Based on NEER\'s classification, the distribution of fractures was as follows: two-part fractures accounted for 18.18% (n = 6) of cases, three-part fractures for 54.54% (n = 18) of cases, and four-part fractures for 27.27% (n = 9) of cases. A history of road traffic accidents and falls was reported in 54.54% (n = 18) and 45.45% (n = 15) of cases, respectively. Functional outcome assessment utilizing NEER\'s score revealed a minimum score of 48 and a maximum of 96, with an average score of 82.96 ± 12.73. Notably, 39% of patients demonstrated excellent results, 27% exhibited satisfactorily, 21% manifested unsatisfactorily, and 12.12% presented failure outcomes. Of the 33 operated cases, 81.8% (n = 27) exhibited no complications during follow-up. The predominant complication observed was shoulder stiffness (9.09%, n = 3), followed by Varus mal-union (6.06%, n = 2), and superficial surgical site infection (3.03%, n = 1), managed with debridement and antibiotics leading to subsequent resolution.
CONCLUSIONS: Managing proximal humerus fractures has consistently posed a formidable challenge. Our study indicates that using the PHILOS plate represents a reliable option for addressing such fractures. This plate provides sturdy fixation, facilitates early mobilization, and culminates in exceptional functional outcomes. The insights gained from this study can inform clinical decision-making and guide orthopedic surgeons in selecting the appropriate treatment strategy for proximal humerus fracture patients.
METHODS: In this robust study, 33 cases of proximal humerus fractures underwent surgical management at a prestigious teaching hospital from February 2021 to August 2022 utilizing a proximal humerus internal locking system (PHILOS) plate. The NEER classification was employed to categorize the fractures, and the NEER score was used for functional assessment. It\'s crucial to note that individuals with pathological fractures, associated injuries in the ipsilateral limb, nerve injuries, and cases of open fracture were rigorously excluded from the study.
RESULTS: The mean age was 47 ± 5.2 years. Based on NEER\'s classification, the distribution of fractures was as follows: two-part fractures accounted for 18.18% (n = 6) of cases, three-part fractures for 54.54% (n = 18) of cases, and four-part fractures for 27.27% (n = 9) of cases. A history of road traffic accidents and falls was reported in 54.54% (n = 18) and 45.45% (n = 15) of cases, respectively. Functional outcome assessment utilizing NEER\'s score revealed a minimum score of 48 and a maximum of 96, with an average score of 82.96 ± 12.73. Notably, 39% of patients demonstrated excellent results, 27% exhibited satisfactorily, 21% manifested unsatisfactorily, and 12.12% presented failure outcomes. Of the 33 operated cases, 81.8% (n = 27) exhibited no complications during follow-up. The predominant complication observed was shoulder stiffness (9.09%, n = 3), followed by Varus mal-union (6.06%, n = 2), and superficial surgical site infection (3.03%, n = 1), managed with debridement and antibiotics leading to subsequent resolution.
CONCLUSIONS: Managing proximal humerus fractures has consistently posed a formidable challenge. Our study indicates that using the PHILOS plate represents a reliable option for addressing such fractures. This plate provides sturdy fixation, facilitates early mobilization, and culminates in exceptional functional outcomes. The insights gained from this study can inform clinical decision-making and guide orthopedic surgeons in selecting the appropriate treatment strategy for proximal humerus fracture patients.
摘要：
背景：肱骨近端骨折主要常见于老年组。管理这种移位和粉碎性骨折模式的适当方法通常令人怀疑。因此，本研究旨在评估肱骨近端骨折在使用肱骨近端锁定钢板治疗后的功能结局,并评估此类患者的并发症发生率.
方法：在这项稳健的研究中，2021年2月至2022年8月，33例肱骨近端骨折患者在一家著名的教学医院接受了手术治疗，采用肱骨近端内部锁定系统（PHILOS）钢板。NEER分类用于对骨折进行分类，NEER评分用于功能评估。重要的是要注意病理性骨折的人，同侧肢体的相关损伤，神经损伤,开放性骨折病例被严格排除在研究之外.
结果：平均年龄为47±5.2岁。根据NEER的分类，骨折的分布如下：两部分骨折占病例的18.18％（n=6），三部分骨折占54.54%(n=18)的病例，四部分骨折占27.27%(n=9)。54.54%(n=18)和45.45%(n=15)的病例报告有道路交通事故和跌倒史,分别。使用NEER评分进行的功能结局评估显示，最低评分为48分，最高评分为96分，平均评分为82.96±12.73分。值得注意的是,39%的患者表现出优异的效果，27%表现令人满意，21%的人表现不令人满意，12.12%呈现失败结果。在33例手术病例中，81.8％（n=27）在随访期间未出现并发症。观察到的主要并发症是肩关节僵硬（9.09%，n=3),其次是Varusmal-union(6.06%，n=2),和浅表手术部位感染（3.03%，n=1),用清创和抗生素管理，导致随后的解决。
结论：处理肱骨近端骨折一直是一个巨大的挑战。我们的研究表明，使用PHILOS钢板是解决此类骨折的可靠选择。这个板提供了坚固的固定，促进早期动员，并最终导致出色的功能结果。从这项研究中获得的见解可以为临床决策提供信息，并指导骨科医师为肱骨近端骨折患者选择合适的治疗策略。
方法：在这项稳健的研究中，2021年2月至2022年8月，33例肱骨近端骨折患者在一家著名的教学医院接受了手术治疗，采用肱骨近端内部锁定系统（PHILOS）钢板。NEER分类用于对骨折进行分类，NEER评分用于功能评估。重要的是要注意病理性骨折的人，同侧肢体的相关损伤，神经损伤,开放性骨折病例被严格排除在研究之外.
结果：平均年龄为47±5.2岁。根据NEER的分类，骨折的分布如下：两部分骨折占病例的18.18％（n=6），三部分骨折占54.54%(n=18)的病例，四部分骨折占27.27%(n=9)。54.54%(n=18)和45.45%(n=15)的病例报告有道路交通事故和跌倒史,分别。使用NEER评分进行的功能结局评估显示，最低评分为48分，最高评分为96分，平均评分为82.96±12.73分。值得注意的是,39%的患者表现出优异的效果，27%表现令人满意，21%的人表现不令人满意，12.12%呈现失败结果。在33例手术病例中，81.8％（n=27）在随访期间未出现并发症。观察到的主要并发症是肩关节僵硬（9.09%，n=3),其次是Varusmal-union(6.06%，n=2),和浅表手术部位感染（3.03%，n=1),用清创和抗生素管理，导致随后的解决。
结论：处理肱骨近端骨折一直是一个巨大的挑战。我们的研究表明，使用PHILOS钢板是解决此类骨折的可靠选择。这个板提供了坚固的固定，促进早期动员，并最终导致出色的功能结果。从这项研究中获得的见解可以为临床决策提供信息，并指导骨科医师为肱骨近端骨折患者选择合适的治疗策略。
