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标题:Comparison of intramedullary fibular allograft with locking compression plate versus shoulder hemi-arthroplasty for repair of osteoporotic four-part proximal humerus fracture: Consecutive, prospective, controlled, and comparative study.
时间:2019-12-03 22:45:16
DOI:10.1016/j.otsr.2015.12.021
PMID:26947731
作者:Chen H;Ji X;Gao Y
关键词:Four-part proximal humeral fracture;Locking compression plate;Intramedullary fibular allograft;Shoulder hemi-arthroplasty
摘要:To compare the outcomes of intramedullary fibular allograft (IFA) with locking compression plates (LCPs) versus shoulder hemi-arthroplasty (HA) in osteoporotic four-part proximal humeral fracture (PHF). Between January 2010 and December 2012, totally 60 cases with osteoporotic four-part PHF were enrolled in this study and were randomly separated into IFA and LCPs group and HA group (n=30). Additionally, surgery indexes for patients in the two groups, such as Constant-Murley score (CMS), the Disability of Arm, Shoulder and Hand (DASH) score, individual subject evaluation of the outcomes, plain X-ray, and computer tomography (CT) scanning were evaluated and compared. CMS, DASH score, activities of daily living (ADL), and range of motion (ROM) were statistically higher in the IFA and LCPs group than those in the HA group at the last follow-up, whereas the pain were obviously lower than that in the HA group. Besides, patients in the IFA and LCPs group had higher abduction, external rotation with elbow, strength, and satisfactory rating compared with HA group at the last follow-up. However, one case developed avascular necrosis (AVN), one case encountered screw perforation, and one case experienced varus displacement in the IFA and LCPs group, while there were 2, 4, and 2 cases suffered from superficial infection, shoulder stiffness, tuberosity migration in the HA group, respectively. IFA with LCP have an advantage in functional outcomes than shoulder HA. Level II. Prospective cohort study.
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目录:
  • Comparison of intramedullary fibular allograft with locking compression plate versus shoulder hemi-arthroplasty for repair...
    • 1 Introduction
    • 2 Materials and methods
      • 2.1 Subjects
      • 2.2 Operative technique
      • 2.3 IFA with LCP intervention
      • 2.4 HA intervention
      • 2.5 Postoperative rehabilitation
      • 2.6 Postoperative evaluation
        • 2.6.1 Clinical evaluation
        • 2.6.2 Radiological evaluation
      • 2.7 Statistical analysis
    • 3 Results
      • 3.1 Patients
      • 3.2 Clinical evaluation and radiologic outcomes
    • 4 Discussion
    • 5 Conclusions
    • Funding
    • Disclosure of interest
    • References

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