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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2.	Neer CS 2nd. Four-segment classification of proximal humeral fractures: purpose and reliable use. J Shoulder Elbow Surg, 2002, 11(4): 389-400.
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12.	萬永鮮, 徐麗麗, 魯小波, 等.人工肱骨頭置換治療肱骨近端復雜骨折18例療效分析.中國修復重建外科雜志, 2012, 26(2): 205-207.
13.	楊勝武, 李悅, 王健, 等.人工肱骨頭置換術治療高齡復雜肱骨近端骨折.中華手外科雜志, 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.	朱林偉.鎖定鋼板治療肱骨近端骨折中肱骨頸干角重建對療效影響的研究.中國修復重建外科雜志, 2015, 29(6): 672-677.
16.	于連祥, 王林, 劉慶鵬, 等.肱骨近端鎖定鋼板治療肱骨近端粉碎性骨折的療效分析.中華創傷骨科雜志, 2012, 14(6): 513-517.
17.	胡稷杰, 魏寬海, 金丹, 等. AO肱骨近端鎖定系統在肱骨近端骨折治療中的應用.中華創傷骨科雜志, 2010, 12(11): 1079-1081.
18.	付中國, 鄧磊, 白露, 等.肱骨近端骨折鎖定接骨板治療術后并發癥分析.北京大學學報(醫學版), 2011, 43(5): 666-670.

1. Ruedi TP, Murphy WM.骨折治療的AO原則.王滿宜, 譯.北京:華夏出版社, 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. 俞銀賢, 吳曉明, 王秋根.交鎖髓內釘治療肱骨近端骨折.中華創傷骨科雜志, 2012, 14(12): 1092-1094.
5. 曾浪清, 陳云豐, 王磊, 等.鎖定鋼板治療Neer三部分四部分肱骨近端骨折療效.中國修復重建外科雜志, 2012, 26(12): 1469-1472.
6. 錢臣. Philos鋼板結合同種異體骨治療骨質疏松性肱骨外科頸骨折.實用骨科雜志, 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. 黃強, 王滿宜, 榮國威.復雜肱骨近端骨折的手術治療.中華骨科雜志, 2005, 25(3): 159-164.
11. 姜保國, 陳建海.肱骨近端骨折的治療.北京大學學報(醫學版), 2012, 44(6): 821-823.
12. 萬永鮮, 徐麗麗, 魯小波, 等.人工肱骨頭置換治療肱骨近端復雜骨折18例療效分析.中國修復重建外科雜志, 2012, 26(2): 205-207.
13. 楊勝武, 李悅, 王健, 等.人工肱骨頭置換術治療高齡復雜肱骨近端骨折.中華手外科雜志, 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. 朱林偉.鎖定鋼板治療肱骨近端骨折中肱骨頸干角重建對療效影響的研究.中國修復重建外科雜志, 2015, 29(6): 672-677.
16. 于連祥, 王林, 劉慶鵬, 等.肱骨近端鎖定鋼板治療肱骨近端粉碎性骨折的療效分析.中華創傷骨科雜志, 2012, 14(6): 513-517.
17. 胡稷杰, 魏寬海, 金丹, 等. AO肱骨近端鎖定系統在肱骨近端骨折治療中的應用.中華創傷骨科雜志, 2010, 12(11): 1079-1081.
18. 付中國, 鄧磊, 白露, 等.肱骨近端骨折鎖定接骨板治療術后并發癥分析.北京大學學報(醫學版), 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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