Zhonghua wai ke za zhi [Chinese journal of surgery] · 2000
[Operative treatment of displaced proximal humeral fractures: follow-up and analysis of 31 patients'].
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Huang Q, Jiang X, Geng X, Wang M
Аннотация
OBJECTIVE: To study the methods and the results of operative treatment of displaced proximal humeral fractures.
METHODS: We reviewed thirty-one patients who had been diagnosed as having displaced proximal humeral fractures and had been operated on from July 1989 to December. 1998 in our hospital. The mean follow-up time was 40.5 months (8 - 124 months). Their age ranged from 15 to 62 years (average, 36.8 years); 18 patients were male and 13 female. Neer fracture classification system and rating system were used. In all patients, delto-pectoral approach was adopted. Twelve fractures were fixed with plates, fifteen fractures with screws, and four fractures with Kirschner wire and plaster.
RESULTS: Of two-part surgical neck fractures, nine of thirteen patients (69%) were excellent or good with no necrosis and un-union. In three-part or four-part fractures, the rate of satisfaction with open reduction and internal fixation (ORIF) was rather lower. In three-part fractures, the rate of humeral head necrosis was 44%, and in four-part fractures, over 75%.
CONCLUSIONS: In two-part and three-part fractures, ORIF is a better treatment, but care should be taken to avoid using plates. As for classic four-part fractures, the rate of satisfaction with ORIF is poor and the rate of necrosis is higher.
METHODS: We reviewed thirty-one patients who had been diagnosed as having displaced proximal humeral fractures and had been operated on from July 1989 to December. 1998 in our hospital. The mean follow-up time was 40.5 months (8 - 124 months). Their age ranged from 15 to 62 years (average, 36.8 years); 18 patients were male and 13 female. Neer fracture classification system and rating system were used. In all patients, delto-pectoral approach was adopted. Twelve fractures were fixed with plates, fifteen fractures with screws, and four fractures with Kirschner wire and plaster.
RESULTS: Of two-part surgical neck fractures, nine of thirteen patients (69%) were excellent or good with no necrosis and un-union. In three-part or four-part fractures, the rate of satisfaction with open reduction and internal fixation (ORIF) was rather lower. In three-part fractures, the rate of humeral head necrosis was 44%, and in four-part fractures, over 75%.
CONCLUSIONS: In two-part and three-part fractures, ORIF is a better treatment, but care should be taken to avoid using plates. As for classic four-part fractures, the rate of satisfaction with ORIF is poor and the rate of necrosis is higher.