EFFECTIVENESS OF OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING ANATOMICAL PLATE FOR TREATING VALGUS IMPACTED PROXIMAL HUMERUS FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LIHongjun , LIUYongguo , WANGJianjun , CHENGGuoxiang , WANGJie

Department of Orthopaedics, Affiliated Huangpi Hospital of Jianghan University, Wuhan Hubei, 430300, P.R.China;

Corresponding author：

LIHongjun, Email: lihongjun7172@163.com

Keywords：

Proximal humerus; Valgus impacted fracture; Locking anatomical plate; Internal fixation

DOI：

10.7507/1002-1892.20160070

Video：

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Objective To investigate the effectiveness of open reduction and internal fixation with locking anatomical plate for treating valgus impacted proximal humerus fracture. Methods A retrospective analysis was made on the clinical data of 38 patients with valgus impacted proximal humerus fracture who underwent open reduction and internal fixation with locking anatomical plate between January 2009 and January 2014. There were 25 males and 13 females, aged from 47 to 63 years (mean, 52.3 years); the left and the right sides were involved in 18 and 20 cases, respectively. The causes of fracture included high falling injury in 10 cases, traffic accident injury in 15 cases, and falling injury in 13 cases. The time between injury and operation was 5-10 days (mean, 7.5 days). The collodiaphyseal angle was 160-200° (mean, 176°) on X-ray films. Results All incisions healed by first intention, and there was no early complication related to operation. All these patients were followed up 12-30 months (mean, 18 months). X-ray film showed that clinical healing time of fracture was 10-16 weeks after operation (mean, 12 weeks); at 12 months after operation, the collodiaphyseal angle recovered to 120-145° (mean, 135°). During follow-up, no loss of fracture reduction and no loosening of internal fixation were observed. At 10-12 months, osteonecrosis of the humeral head occurred in 3 cases (7.9%), including 2 cases of Cruess stageⅢand 1 case of Cruess stageⅣ. At last follow-up, the Constant shoulder joint scores were 56-95 (mean, 82.6); the results were excellent in 10 cases, good in 15 cases, fair in 9 cases, and poor in 4 cases, with an excellent and good rate of 66%. Visual analogue scale (VAS) scores were 0-6 (mean, 0.9). Conclusion It can achieve a comparatively satisfactory clinical result to use open reduction and internal fixation with locking anatomical plate for treating valgus impacted proximal humerus fracture.

Citation： LIHongjun, LIUYongguo, WANGJianjun, CHENGGuoxiang, WANGJie. EFFECTIVENESS OF OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING ANATOMICAL PLATE FOR TREATING VALGUS IMPACTED PROXIMAL HUMERUS FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(3): 359-362. doi: 10.7507/1002-1892.20160070 Copy

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11.	姜保国, 陈建海.肱骨近端骨折的治疗.北京大学学报(医学版), 2012, 44(6): 821-823.
12.	万永鲜, 徐丽丽, 鲁小波, 等.人工肱骨头置换治疗肱骨近端复杂骨折18例疗效分析.中国修复重建外科杂志, 2012, 26(2): 205-207.
13.	杨胜武, 李悦, 王健, 等.人工肱骨头置换术治疗高龄复杂肱骨近端骨折.中华手外科杂志, 2006, 22(6): 339-341.
14.	Court-Browmn CM, Cattermole H, McQueen MM. Impacted valgus fracture (B1.1) of the proximal humerus. The results of non-operative treatment. J Bone Joint Surg (Br), 2002, 84(4): 504-508.
15.	朱林伟.锁定钢板治疗肱骨近端骨折中肱骨颈干角重建对疗效影响的研究.中国修复重建外科杂志, 2015, 29(6): 672-677.
16.	于连祥, 王林, 刘庆鹏, 等.肱骨近端锁定钢板治疗肱骨近端粉碎性骨折的疗效分析.中华创伤骨科杂志, 2012, 14(6): 513-517.
17.	胡稷杰, 魏宽海, 金丹, 等. AO肱骨近端锁定系统在肱骨近端骨折治疗中的应用.中华创伤骨科杂志, 2010, 12(11): 1079-1081.
18.	付中国, 邓磊, 白露, 等.肱骨近端骨折锁定接骨板治疗术后并发症分析.北京大学学报(医学版), 2011, 43(5): 666-670.

1. Ruedi TP, Murphy WM.骨折治疗的AO原则.王满宜, 译.北京:华夏出版社, 2005: 283.
2. Neer CS 2nd. Four-segment classification of proximal humeral fractures: purpose and reliable use. J Shoulder Elbow Surg, 2002, 11(4): 389-400.
3. Keener JD, Parsons BO, Flatow EL, et al. Outcomes after percutaneous reduction and fixation of proximal humerus fractures. J Shoulder Elbow Surg, 2007, 16(3): 330-338.
4. 俞银贤, 吴晓明, 王秋根.交锁髓内钉治疗肱骨近端骨折.中华创伤骨科杂志, 2012, 14(12): 1092-1094.
5. 曾浪清, 陈云丰, 王磊, 等.锁定钢板治疗Neer三部分四部分肱骨近端骨折疗效.中国修复重建外科杂志, 2012, 26(12): 1469-1472.
6. 钱臣. Philos钢板结合同种异体骨治疗骨质疏松性肱骨外科颈骨折.实用骨科杂志, 2015, 21(2): 163-165.
7. Cruess RL. Experience with steroid-induced avascular necrosis of the shouder and etiologic considerations regarding osteonecrosis of the hip. Clin Orthop Relat Res, 1978, 130(3): 86-93.
8. Constant CR, Murley AH. A clinical method of functional assessment of the shouder. Clin Orthop Relat Res, 1987, 214: 160-164.
9. Magovem B, Ramsey ML. Percutaneous fixation of proximal humerus fractures. Orthop Clin North Am, 2008, 39(4): 405-416.
10. 黄强, 王满宜, 荣国威.复杂肱骨近端骨折的手术治疗.中华骨科杂志, 2005, 25(3): 159-164.
11. 姜保国, 陈建海.肱骨近端骨折的治疗.北京大学学报(医学版), 2012, 44(6): 821-823.
12. 万永鲜, 徐丽丽, 鲁小波, 等.人工肱骨头置换治疗肱骨近端复杂骨折18例疗效分析.中国修复重建外科杂志, 2012, 26(2): 205-207.
13. 杨胜武, 李悦, 王健, 等.人工肱骨头置换术治疗高龄复杂肱骨近端骨折.中华手外科杂志, 2006, 22(6): 339-341.
14. Court-Browmn CM, Cattermole H, McQueen MM. Impacted valgus fracture (B1.1) of the proximal humerus. The results of non-operative treatment. J Bone Joint Surg (Br), 2002, 84(4): 504-508.
15. 朱林伟.锁定钢板治疗肱骨近端骨折中肱骨颈干角重建对疗效影响的研究.中国修复重建外科杂志, 2015, 29(6): 672-677.
16. 于连祥, 王林, 刘庆鹏, 等.肱骨近端锁定钢板治疗肱骨近端粉碎性骨折的疗效分析.中华创伤骨科杂志, 2012, 14(6): 513-517.
17. 胡稷杰, 魏宽海, 金丹, 等. AO肱骨近端锁定系统在肱骨近端骨折治疗中的应用.中华创伤骨科杂志, 2010, 12(11): 1079-1081.
18. 付中国, 邓磊, 白露, 等.肱骨近端骨折锁定接骨板治疗术后并发症分析.北京大学学报(医学版), 2011, 43(5): 666-670.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING ANATOMICAL PLATE FOR TREATING VALGUS IMPACTED PROXIMAL HUMERUS FRACTURE

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