Treatment of four-part proximal humerus fractures with depressed humeral head collapse using strut allograft with locking plates.
10.12200/j.issn.1003-0034.2023.02.004
- Author:
Lie LIU
1
;
Feng YANG
1
;
Cheng-Cheng ZONG
1
;
Jing CHEN
1
Author Information
1. Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China.
- Publication Type:Journal Article
- Keywords:
Allogeneic bone;
Locking plate;
Proximal humeral fractures;
Strut allograft;
Surgical treatment
- MeSH:
Male;
Female;
Humans;
Middle Aged;
Aged;
Humeral Head;
Shoulder;
Treatment Outcome;
Bone Plates;
Retrospective Studies;
Humerus;
Shoulder Fractures/surgery*;
Fracture Fixation, Internal/adverse effects*;
Humeral Fractures;
Allografts
- From:
China Journal of Orthopaedics and Traumatology
2023;36(2):116-119
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the clinical outcomes of allogeneic femoral head as strut allograft combined with proximal humeral internal locking system (PHILOS) in the treatment of proximal humeral Neer grade Ⅳ fracture with humeral head collapse.
METHODS:From January 2018 to November 2020, 18 patients with Neer grade Ⅳ fracture with humeral head collapse were treated with strut allograft with PHILOS, including 4 males and 14 females, aged from 55 to 78 years old, with an average of (68.11±7.20) years old. The operation time, intraoperative bleeding, postoperative drainage volume, fracture healing time, neck-shaft angle and the height of the humeral head, failure of internal fixation the shoulder function at the last follow-up was assessed using Neer's scoring system.
RESULTS:All 18 patients were followed up, and the duration ranged from 10 to 12 months, with an average of (11.08±0.65) months. The operation time was (66.44±5.06) min, the intraoperative bleeding volume was (206.67±36.14) ml, the postoperative drainage volume was (76.11±9.63) ml, and the fracture healing time was (17.28±3.92) weeks. At the last follow-up, the degree of loss of neck-shaft angle was (5.44±0.86) ° and the loss of the height of humeral head was (1.43±0.27) mm. All 18 patients had healing without complications such as fracture, withdrawal, penetration of internal fixation and necrosis of humeral head. According to Neer's evaluation standard, the total score was (89.61±5.60), 10 cases got an excellent result, 6 good, 2 fair.
CONCLUSION:Allogeneic femoral head combined with PHILOS is an appropriate treatment for the four-part proximal humerus fractures with humeral head collapse, exhibiting good clinic outcome.
