Treatment of the aged patients with unstable proximal humeral fracture with a locking plate and an intramedullary titanium mesh
10.3760/cma.j.cn115530-20221021-00523
- VernacularTitle:锁定钢板结合髓内钛网支撑治疗老年肱骨近端骨折的疗效分析
- Author:
Hui CHEN
1
;
Yunfeng RUI
;
Xueliang CUI
;
He LI
;
Liu SHI
;
Xuan WU
;
Wenbin FAN
;
Junyi GAO
Author Information
1. 东南大学附属中大医院骨科，东南大学附属中大医院创伤中心，东南大学创伤骨科研究所，南京 210009
- Keywords:
Shoulder joint;
Aged;
Fracture fixation, internal;
Proximal humeral fractures;
Locking plate;
Titanium mesh
- From:
Chinese Journal of Orthopaedic Trauma
2023;25(5):422-426
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the radiological and clinical outcomes of the aged patients with unstable proximal humeral fracture (UPHF) treated with a locking plate and an intramedullary titanium mesh.Methods:A retrospective study was conducted to analyze the 43 aged patients with UPHF who had been admitted to Department of Orthopedics, Zhongda Hospital Affiliated to Southeast University from January 2017 to July 2019. There were 13 males and 30 females with an age of (71.3±10.3) years (from 60 to 83 years). All patients were treated with a locking plate and an intramedullary titanium mesh to support. The postoperative imaging measurements included changes in humeral head height (HHH) and neck-shaft angle (NSA) (the difference between 3 years after surgery and the second day after surgery, taken as an absolute value); the postoperative clinical measurements included visual analogue scale (VAS), range of shoulder motion, Constant-Murley shoulder functional score (Constant score), American Shoulder and Elbow Surgeons (ASES) score, and incidence of complications.Results:All patients were followed up for (39.2±2.3) months after surgery. The change in HHH at 3 years after surgery was (1.5±1.1) mm, and the change in NSA at 3 years after surgery 3.3°±2.6°. At 3 years after surgery, the VAS score was (2.2±1.3) points, the Constant score (79.2±9.1) points, and the ASES score (78.9±9.2) points; the range of forward extension was 143.2°±20.8°, the range of outward extension 139.3°±23.1°, and the range of outward rotation 55.1°±4.7°. Complications after surgery were found in 6 patients, including humeral head necrosis in 2 cases, ectopic ossification in 1 case, and infection in 3 cases.Conclusion:In the treatment of the aged patients with UPHF, a locking plate combined with an intramedullary titanium mesh can help to restore the medial column support, leading to fine radiological and clinical outcomes.
