Postoperative complications of complex proximal humeral fractures after treated with proximal humeral internal locking system plate fixation
10.3969/j.issn.2095-4344.2013.48.014
- VernacularTitle:肱骨近端锁定加压钢板置入内固定治疗复杂肱骨近端骨折的并发症
- Author:
Fuyuan MA
;
Tieyi YANG
;
Rui JIANG
;
Yan ZHANG
;
Yue LIU
;
Jin SHAO
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2013;(48):8381-8387
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Proximal humeral internal locking system fixation for complex humeral fractures via deltoid splitting approach provides good clinical results, but certain complications stil existed.
OBJECTIVE:To explore the postoperative complications and the related risk factors for displaced three-part and four-part fractures of proximal humerus treated with proximal humeral internal locking system fixation via deltoid-splitting approach, and to propose the corresponding countermeasures.
METHODS:106 cases with displaced three-part and four-part fractures of proximal humerus were retrospectively analyzed. The relationship between postoperative complications and the related risk factors was analyzed with Logistic regression analysis.
RESULTS AND CONCLUSION:A total of 81 patients were fol owed-up for 12 to 30 months. The mean Constant score at 12 months after operation was (76.57±4.70) points. The postoperative complications occurred in 31 patients (38.3%) of which impingement syndrome involved in 16 cases (19.8%), head-shaft angle loss in six cases (7.4%), head-shaft angle loss combined with screws cut-out in two cases (2.5%), pure screws cut-out in two cases (2.5%), humeral head necrosis in two cases (2.5%), fat liquefaction in five cases (6.2%). Single factor analysis showed that there were significant differences in the superiorly located greater tuberosity, superiorly located plate and Neer classification between impingement group and un-impinged group (P<0.05). There were statistical y significant differences in age, postoperative medial cortical defects and Neer classification between head-shaft angle loss group and un-loss group (P<0.05). By means of logistic regression analysis, the superiorly located greater tuberosity, superiorly located plate and Neer classification were the individual predictors for postoperative impingement syndrome;postoperative medial cortical defect and Neer classification were the individual predictors for postoperative head-shaft angle loss.
