Klinik Araştırma
BibTex RIS Kaynak Göster
Yıl 2023, Cilt: 16 Sayı: 2, 35 - 39, 08.08.2023

Öz

Kaynakça

  • 1. Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand. 2001;72(4):365-371.
  • 2. Passaretti D, Candela V, Sessa P, Gumina S. Epidemiology of proximal humeral fractures: a detailed survey of 711 patients in a metropoli-tan area. J Shoulder Elbow Surg. 2017;26(12):2117-124.
  • 3. Iglesias-Rodríguez S, Domínguez-Prado DM, García-Reza A, Fernández-Fernández D, Pérez-Alfonso E, García-Piñeiro J, et al. Epidemiology of proximal humerus fractures. J Orthop Surg Res. 2021;16(1):402.
  • 4. Patel AH, Wilder JH, Ofa SA, Lee OC, Savoie FH, 3rd, O'Brien MJ, et al. Trending a decade of proximal humerus fracture management in ol-der adults. JSES Int. 2022;6(1):137-143.
  • 5. McLean AS, Price N, Graves S, Hatton A, Tay-lor FJ. Nationwide trends in management of proximal humeral fractures: an analysis of 77,966 cases from 2008 to 2017. J Shoulder El-bow Surg. 2019;28(11):2072-2078.
  • 6. Court-Brown CM, Cattermole H, McQueen MM. Impacted valgus fractures (B1.1) of the proximal humerus. The results of non-operative treatment. J Bone Joint Surg Br. 2002;84(4):504-508.
  • 7. Thorsness R, English C, Gross J, Tyler W, Volos-hin I, Gorczyca J. Proximal humerus fractures with associated axillary artery injury. J Orthop Trauma. 2014 Nov;28(11):659-663.
  • 8. Koval KJ, Gallagher MA, Marsicano JG, Cuomo F, McShinawy A, Zuckerman JD. Functional outcome after minimally displaced fractures of the proximal part of the humerus. J Bone Joint Surg Am. 1997;79(2):203-207.
  • 9. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Ort-hop Relat Res. 1987(214):160-164.
  • 10. Beks RB, Ochen Y, Frima H, Smeeing DPJ, van der Meijden O, Timmers TK, et al. Operative versus nonoperative treatment of proximal hu-meral fractures: a systematic review, meta-analysis, and comparison of observational stu-dies and randomized controlled trials. J Shoul-der Elbow Surg. 2018;27(8):1526-1534.
  • 11. Jawa A, Burnikel D. Treatment of Proximal Humeral Fractures: A Critical Analysis Review. JBJS Rev. 2016;4(1).
  • 12. Maier D, Jaeger M, Izadpanah K, Strohm PC, Suedkamp NP. Proximal humeral fracture tre-atment in adults. J Bone Joint Surg Am. 2014;96(3):251-261.
  • 13. Handoll HH, Brorson S. Interventions for trea-ting proximal humeral fractures in adults. Cochrane Database Syst Rev. 2015(11):Cd000434.
  • 14. Boileau P, Caligaris-Cordero B, Payeur F, Tinsi L, Argenson C. [Prognostic factors during reha-bilitation after shoulder prostheses for fracture]. Rev Chir Orthop Reparatrice Appar Mot. 1999;85(2):106-116.
  • 15. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359(9319):1761-1767.
  • 16. Mills HJ, Horne G. Fractures of the proximal humerus in adults. J Trauma. 1985;25(8):801-805.
  • 17. Walsh S, Reindl R, Harvey E, Berry G, Beck-man L, Steffen T. Biomechanical comparison of a unique locking plate versus a standard pla-te for internal fixation of proximal humerus fractures in a cadaveric model. Clin Biomech (Bristol, Avon). 2006;21(10):1027-1031.
  • 18. Egol KA, Ong CC, Walsh M, Jazrawi LM, Tejwani NC, Zuckerman JD. Early complicati-ons in proximal humerus fractures (OTA Types 11) treated with locked plates. J Orthop Trau-ma. 2008;22(3):159-164.
  • 19. Sun JC, Li YL, Ning GZ, Wu Q, Feng SQ. Treat-ment of three- and four-part proximal humeral fractures with locking proximal humerus plate. Eur J Orthop Surg Traumatol. 2013;23(6):699-704.
  • 20. Yang H, Li Z, Zhou F, Wang D, Zhong B. A prospective clinical study of proximal humerus fractures treated with a locking proximal hume-rus plate. J Orthop Trauma. 2011;25(1):11-17.
  • 21. Erpala F, Tahta M, Öztürk T, Zengin Ç. Compa-rison of Treatment Options of Three- and Four-Part Humerus Proximal Fractures in Patients Over 50 Years of Age. Cureus. 2021;13(8):e17516.
  • 22. Soler-Peiro M, García-Martínez L, Aguilella L, Perez-Bermejo M. Conservative treatment of 3-part and 4-part proximal humeral fractures: a systematic review. J Orthop Surg Res. 2020;15(1):347.
  • 23. Iyengar JJ, Devcic Z, Sproul RC, Feeley BT. Nonoperative treatment of proximal humerus fractures: a systematic review. J Orthop Trau-ma. 2011;25(10):612-617.
  • 24. Hessmann M, Baumgaertel F, Gehling H, Klin-gelhoeffer I, Gotzen L. Plate fixation of proximal humeral fractures with indirect reduc-tion: surgical technique and results utilizing three shoulder scores. Injury. 1999;30(7):453-462.
  • 25. Neer CS, 2nd. Four-segment classification of proximal humeral fractures: purpose and reliab-le use. J Shoulder Elbow Surg. 2002;11(4):389-400.
  • 26. Boons HW, Goosen JH, van Grinsven S, van Susante JL, van Loon CJ. Hemiarthroplasty for humeral four-part fractures for patients 65 ye-ars and older: a randomized controlled trial. Clin Orthop Relat Res. 2012;470(12):3483-3491.
  • 27. Olerud P, Ahrengart L, Ponzer S, Saving J, Ti-dermark J. Hemiarthroplasty versus nonopera-tive treatment of displaced 4-part proximal humeral fractures in elderly patients: a rando-mized controlled trial. J Shoulder Elbow Surg. 2011;20(7):1025-1033.
  • 28. Solberg BD, Moon CN, Franco DP, Paiement GD. Locked plating of 3- and 4-part proximal humerus fractures in older patients: the effect of initial fracture pattern on outcome. J Orthop Trauma. 2009;23(2):113-119.

Clinical and radiological results of locking plate surgical treatment in patients over 65 years of age with neer type 3-4 proximal humerus fractures

Yıl 2023, Cilt: 16 Sayı: 2, 35 - 39, 08.08.2023

Öz

Our objective was to evaluate the locking plate osteosynthesis (OS) results in treating three- and four-part humeral fractures in patients older than 65 years.
Twenty-eight patients who underwent plate osteosynthesis for proximal humerus fracture between 2017 and 2021 and had at least one year of follow-up were included in the study. The Constant-Murley shoulder score (0-55 points: poor, 56-70 points: moderate, 71-85 points: good, 86-100 points: very good), shoulder motion in all directions, pain, and performing daily activities of daily living at postoperative follow-up of the shoulder range of motion was also assessed.
The mean age of our patients was 75.14 (66-94). The mean follow-up time was 58.8 (18-73) months. One of our patients developed avascular necrosis in the humeral head, and two of our patients underwent partial shoulder arthroplasty when union could not be achieved. Graphic follow-up revealed that the plate caused subacromial compression in 5 patients, that the locking screw loosened in 3 patients, that 1 (3.22%) screw in the humeral head migrated into the joint in 3 patients in the postoperative period, and that the humeral head fused in varus position in 6 patients. In 3 of our patients, the screws that had migrated into the joint were removed. Hemiarthroplasty was performed in one patient with avascular necrosis and two patients with nonunion. The mean Constant-Murley shoulder score was calculated to be 49.74 (23-98). It was considered excellent in 2 (6.45%) patients, good in 2 patients, moderate in 6 patients, and poor in 18 (67.74%) patients. Infections, vascular and nerve damage did not occur in our patients.
Considering osteoporosis in three-part and four-part fractures of the proximal humerus of Neer, the results of plate osteosynthesis treatment are not successful in patients with advanced age, additional morbidity and high surgical risk.

Kaynakça

  • 1. Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand. 2001;72(4):365-371.
  • 2. Passaretti D, Candela V, Sessa P, Gumina S. Epidemiology of proximal humeral fractures: a detailed survey of 711 patients in a metropoli-tan area. J Shoulder Elbow Surg. 2017;26(12):2117-124.
  • 3. Iglesias-Rodríguez S, Domínguez-Prado DM, García-Reza A, Fernández-Fernández D, Pérez-Alfonso E, García-Piñeiro J, et al. Epidemiology of proximal humerus fractures. J Orthop Surg Res. 2021;16(1):402.
  • 4. Patel AH, Wilder JH, Ofa SA, Lee OC, Savoie FH, 3rd, O'Brien MJ, et al. Trending a decade of proximal humerus fracture management in ol-der adults. JSES Int. 2022;6(1):137-143.
  • 5. McLean AS, Price N, Graves S, Hatton A, Tay-lor FJ. Nationwide trends in management of proximal humeral fractures: an analysis of 77,966 cases from 2008 to 2017. J Shoulder El-bow Surg. 2019;28(11):2072-2078.
  • 6. Court-Brown CM, Cattermole H, McQueen MM. Impacted valgus fractures (B1.1) of the proximal humerus. The results of non-operative treatment. J Bone Joint Surg Br. 2002;84(4):504-508.
  • 7. Thorsness R, English C, Gross J, Tyler W, Volos-hin I, Gorczyca J. Proximal humerus fractures with associated axillary artery injury. J Orthop Trauma. 2014 Nov;28(11):659-663.
  • 8. Koval KJ, Gallagher MA, Marsicano JG, Cuomo F, McShinawy A, Zuckerman JD. Functional outcome after minimally displaced fractures of the proximal part of the humerus. J Bone Joint Surg Am. 1997;79(2):203-207.
  • 9. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Ort-hop Relat Res. 1987(214):160-164.
  • 10. Beks RB, Ochen Y, Frima H, Smeeing DPJ, van der Meijden O, Timmers TK, et al. Operative versus nonoperative treatment of proximal hu-meral fractures: a systematic review, meta-analysis, and comparison of observational stu-dies and randomized controlled trials. J Shoul-der Elbow Surg. 2018;27(8):1526-1534.
  • 11. Jawa A, Burnikel D. Treatment of Proximal Humeral Fractures: A Critical Analysis Review. JBJS Rev. 2016;4(1).
  • 12. Maier D, Jaeger M, Izadpanah K, Strohm PC, Suedkamp NP. Proximal humeral fracture tre-atment in adults. J Bone Joint Surg Am. 2014;96(3):251-261.
  • 13. Handoll HH, Brorson S. Interventions for trea-ting proximal humeral fractures in adults. Cochrane Database Syst Rev. 2015(11):Cd000434.
  • 14. Boileau P, Caligaris-Cordero B, Payeur F, Tinsi L, Argenson C. [Prognostic factors during reha-bilitation after shoulder prostheses for fracture]. Rev Chir Orthop Reparatrice Appar Mot. 1999;85(2):106-116.
  • 15. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359(9319):1761-1767.
  • 16. Mills HJ, Horne G. Fractures of the proximal humerus in adults. J Trauma. 1985;25(8):801-805.
  • 17. Walsh S, Reindl R, Harvey E, Berry G, Beck-man L, Steffen T. Biomechanical comparison of a unique locking plate versus a standard pla-te for internal fixation of proximal humerus fractures in a cadaveric model. Clin Biomech (Bristol, Avon). 2006;21(10):1027-1031.
  • 18. Egol KA, Ong CC, Walsh M, Jazrawi LM, Tejwani NC, Zuckerman JD. Early complicati-ons in proximal humerus fractures (OTA Types 11) treated with locked plates. J Orthop Trau-ma. 2008;22(3):159-164.
  • 19. Sun JC, Li YL, Ning GZ, Wu Q, Feng SQ. Treat-ment of three- and four-part proximal humeral fractures with locking proximal humerus plate. Eur J Orthop Surg Traumatol. 2013;23(6):699-704.
  • 20. Yang H, Li Z, Zhou F, Wang D, Zhong B. A prospective clinical study of proximal humerus fractures treated with a locking proximal hume-rus plate. J Orthop Trauma. 2011;25(1):11-17.
  • 21. Erpala F, Tahta M, Öztürk T, Zengin Ç. Compa-rison of Treatment Options of Three- and Four-Part Humerus Proximal Fractures in Patients Over 50 Years of Age. Cureus. 2021;13(8):e17516.
  • 22. Soler-Peiro M, García-Martínez L, Aguilella L, Perez-Bermejo M. Conservative treatment of 3-part and 4-part proximal humeral fractures: a systematic review. J Orthop Surg Res. 2020;15(1):347.
  • 23. Iyengar JJ, Devcic Z, Sproul RC, Feeley BT. Nonoperative treatment of proximal humerus fractures: a systematic review. J Orthop Trau-ma. 2011;25(10):612-617.
  • 24. Hessmann M, Baumgaertel F, Gehling H, Klin-gelhoeffer I, Gotzen L. Plate fixation of proximal humeral fractures with indirect reduc-tion: surgical technique and results utilizing three shoulder scores. Injury. 1999;30(7):453-462.
  • 25. Neer CS, 2nd. Four-segment classification of proximal humeral fractures: purpose and reliab-le use. J Shoulder Elbow Surg. 2002;11(4):389-400.
  • 26. Boons HW, Goosen JH, van Grinsven S, van Susante JL, van Loon CJ. Hemiarthroplasty for humeral four-part fractures for patients 65 ye-ars and older: a randomized controlled trial. Clin Orthop Relat Res. 2012;470(12):3483-3491.
  • 27. Olerud P, Ahrengart L, Ponzer S, Saving J, Ti-dermark J. Hemiarthroplasty versus nonopera-tive treatment of displaced 4-part proximal humeral fractures in elderly patients: a rando-mized controlled trial. J Shoulder Elbow Surg. 2011;20(7):1025-1033.
  • 28. Solberg BD, Moon CN, Franco DP, Paiement GD. Locked plating of 3- and 4-part proximal humerus fractures in older patients: the effect of initial fracture pattern on outcome. J Orthop Trauma. 2009;23(2):113-119.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Kemal Kayaokay 0000-0003-1655-0587

Cemal Kazimoglu 0000-0003-2089-5043

Yayımlanma Tarihi 8 Ağustos 2023
Gönderilme Tarihi 22 Haziran 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 16 Sayı: 2

Kaynak Göster

Vancouver Kayaokay K, Kazimoglu C. Clinical and radiological results of locking plate surgical treatment in patients over 65 years of age with neer type 3-4 proximal humerus fractures. JSurgArts. 2023;16(2):35-9.

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