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标题:Locking plate and fibular allograft augmentation in unstable fractures of proximal humerus
时间:2019-12-03 22:43:33
DOI:10.1016/j.injury.2012.08.004
作者:Fabrizio Matassi; Renzo Angeloni; Christian Carulli
关键词:Proximal humeral fracture;Fibular allograft;Locking plate;Medial support;Endosteal implant
出版源: 《Injury-international Journal of the Care of th... ,43 (11)
摘要:INTRODUCTION: The use of an intramedullary fibular allograft together with a locking plate fixation has been recently described in biomechanical studies to provide additional medial support and prevent varus malalignment for displaced proximal humeral fractures with promising results. The aim of this study was to evaluate the clinical and radiographic outcome of a locking plate with fibular allograft augmentation in unstable humeral fractures.; METHODS: We prospectively assessed the functional outcome and complications in 17 patients with proximal humeral fractures with disrupted medial column, treated with a locking plate and a fibular strut graft. The median patient age was 62 years. Postoperative assessments included radiographic imaging, range of motion, pain according to the visual analogue scale (VAS), Short Form (SF36) Health Survey, Constant-Murley and Disabilities of the Arm, Shoulder and Hand (DASH) shoulder scores as well as return to previous occupation and complications.; RESULTS: No patients were lost to follow-up and no major complications were recorded. There was no collapse of the humeral head more than 2mm, osteonecrosis or screw penetration of the articular surface. All fractures healed clinically and radiographically. After an average follow-up of 13 months, the mean Constant score was 79 points. The mean active flexion was 149掳; extension, 47掳; internal rotation, 40掳; external rotation, 65掳; and abduction, 135掳. The median VAS pain level was 1 point. The median DASH score was 33 points, and the median SF36 was 83 points.; CONCLUSION: Locking plate with fibular graft augmentation is a safe and promising technique to support the humeral head and maintain reduction in the proximal humeral fracture with medial comminution. Copyright 2012 Elsevier Ltd. All rights reserved.
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目录:
  • Locking plate and fibular allograft augmentation in unstable fractures of proximal humerus
    • Introduction
    • Materials and methods
      • Surgical technique
    • Results
    • Discussion
    • Conclusion
    • Conflict of interest
    • References

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