Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Radiologic and Clinical Results between Locking Compression Plate and Unlocked Plate in Proximal Humerus Fractures

근위 상완골 골절에서 잠김 압박 금속판과 비잠김 금속판 고정의 방사선학적 임상적 추시 결과 비교

  • Kim, Jae-Hwa (Department of Orthopaedic Surgery, Bundang CHA Hospital, Pochon CHA University) ;
  • Lee, Yun-Seok (Department of Orthopaedic Surgery, Gumi CHA Hospital, College of Medicne, Pochon CHA University) ;
  • Ahn, Tae-Keun (Department of Orthopaedic Surgery, Bundang CHA Hospital, Pochon CHA University) ;
  • Choi, Jung-Pil (Department of Orthopaedic Surgery, Bundang CHA Hospital, Pochon CHA University)
  • 김재화 (포천중문 의과대학교 분당 차병원 정형외과학교실) ;
  • 이윤석 (포천중문 의과대학교 구미 차병원 정형외과학교실) ;
  • 안태근 (포천중문 의과대학교 분당 차병원 정형외과학교실) ;
  • 최정필 (포천중문 의과대학교 분당 차병원 정형외과학교실)
  • Published : 2008.12.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study is to compare the results of using a locking compression plate and an unlocked plate for treating proximal humeral fractures. Materials and Methods: This study was based on 20 patients who underwent plate fixation for proximal humeral fractures out of the 87 patients with proximal humeral fractures and who were admitted from 2003 to 2007 in our hospital. Of the 20 patients, 10 were treated with a locking compression plate and the other 10 were treated with an unlocked plate. Each group was evaluated according to the humeral neck shaft angle, the period until bony union, the complications and the Constant score. The humeral neck shaft angle was based on plain x-rays taken immediately after the operation and at 6 months postoperatively. The Constant score was evaluated on the last visit to our clinic. Results: There was no significant statistical difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. Yet, there were three cases of screw migration in the unlocked plate group. Conclusion: There was no significant difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. The locking compression plate is considered to achieve more effective fixation for proximal humerus fractures because there were less complications such as screw migration.

목적: 근위 상완골 골절에서 잠김 압박 금속판과 비잠김 금속판 고정의 방사선학적 임상적 추시 결과를 비교 분석하고자 하였다. 대상 및 방법: 2003년부터 2007년 까지 본원에서 근위 상완골 골절로 입원하였던 87명의 환자중 금속판 고정술을 시행 받았던 환자 20명을 대상으로 하였으며 20명의 환자는 잠김 압박 금속판 고정을 시행하였던 환자 10명, 비잠김 금속판 고정을 시행하였던 환자 10명의 두 군으로 나뉘었다. 각각의 환자군은 수술 직후와 수술 후 6개월 뒤 방사선 사진상 상완골의 경간각, 골유합까지 소요된 시간, 합병증의 빈도 그리고 마지막 추시 당시의 Constant score를 측정하여 서로 비교 분석 하였다. 결과: 상완골의 경각간 및 골유합, Constant score에 대해서 두 군은 유의한 차이를 보이지 않았으나 비잠김 금속판을 사용한 군에서 나사 풀림 현상이 3례에서 발견되었다. 결론: 추시 결과상 잠김 압박 금속판의 사용이 비잠김 금속판에 비하여 임상적, 방사선학적으로 유의한 차이는 없었으나 근위 상완골 골절의 치료에서 나사 풀림 현상 등의 합병증이 적은 잠김 압박 금속판을 사용하는 것이 더 효과적일 것으로 사료된다.

Keywords

References

  1. Agel J, Jones CB, Sanzone AG, Camuso M, Henley MB: Treatment of proximal humeral fractures with Polarus nail fixation. Journal of shoulder and elbow surgery. 13: 191-195, 2004. https://doi.org/10.1016/j.jse.2003.12.005
  2. Agudelo J, Schurmann M, Stahel P, Helwig P, Morgan SJ, Zechel W, Bahrs C, Parekh A, Ziran B, Williams A, Smith W: Analysis of efficacy and failure in proximal humerus fractures treated with locking plates. J Orthop Trauma. 21: 676-681, 2007. https://doi.org/10.1097/BOT.0b013e31815bb09d
  3. Bigliani L, Flatow E, Pollock R : Fractures of the proximal humerus Rockwood and Green's fractures in adults. 4th ed. 1: 1055-1107, 1996.
  4. Fakler JK, Hogan C, Heyde CE, John T: Current concepts in the treatment of proximal humeral fractures. Orthopedics. 31: 42-51, 2008. https://doi.org/10.3928/01477447-20080101-13
  5. Fankhauser F, Boldin C, Schippinger G, Haunschmid C, Szyszkowitz R: A new locking plate for unstable fractures of the proximal humerus. Clin Orthop Relat Res. 430: 176-181, 2005.
  6. Hessler C, Schmucker U, Matthes G, Ekkernkamp A, Gutschow R, Eggers C: Results after treatment of instable fractures of the proximal humerus using a fixed-angle plate. Der Unfallchirurg. 109: 867-870, 872-864, 2006. https://doi.org/10.1007/s00113-006-1138-x
  7. Koval KJ, Blair B, Takei R, Kummer FJ, Zuckerman JD: Surgical neck fractures of the proximal humerus: a laboratory evaluation of ten fixation techniques. The Journal of trauma. 40: 778-783, 1996. https://doi.org/10.1097/00005373-199605000-00017
  8. Kristiansen B, Christensen SW: Plate fixation of proximal humeral fractures. Acta orthopaedica Scandinavica. 57(4): 320-323, 1986. https://doi.org/10.3109/17453678608994401
  9. Lill H, Hepp P, Korner J, Kassi JP, Verheyden AP, Josten C, Duda GN: Proximal humeral fractures: how stiff should an implant be? A comparative mechanical study with new implants in human specimens. Archives of orthopaedic and trauma surgery. 123: 74-81, 2003.
  10. Misra A, Kapur R, Maffulli N: Complex proximal humeral fractures in adults--a systematic review of management. Injury. 232: 363-372, 2001.
  11. Owsley KC, Gorczyca JT: Displacement/screw cutout after open reduction and locked plate fixation of humeral fractures. J Bone Joint Surg Am. 90: 233-240, 2008. https://doi.org/10.2106/JBJS.F.01351
  12. Seide K, Triebe J, Faschingbauer M, et al: Locked vs. unlocked plate osteosynthesis of the proximal humerus - a biomechanical study. Clin Biomech (Bristol, Avon). 22(2): 176-182, 2007. https://doi.org/10.1016/j.clinbiomech.2006.08.009
  13. Shin S, Song K, Lee J, et al: Treatment of Two- and Three-Part Fracture of Proximal Humerus using LCP. J of the Korean Shoulder and Elbow Society, 10: 205-211, 2007. https://doi.org/10.5397/CiSE.2007.10.2.204
  14. Stableforth PG: Four-part fractures of the neck of the humerus. J Bone Joint Surg Am. 66: 104-108, 1984.
  15. Young TB, Wallace WA: Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus. J Bone Joint Surg Am. 67: 373-377, 1985.

Cited by

  1. Treatment of Proximal Humeral Fracture Using Polarus Nail and Philos Plate vol.17, pp.3, 2014, https://doi.org/10.5397/cise.2014.17.3.120
  2. Comparison Study of Different Approach (Deltoid Splitting Approach and Delto-pectoral Interval Approach) for Proximal Humeral Fractures vol.16, pp.1, 2013, https://doi.org/10.5397/CiSE.2013.16.1.17