Outcomes of 188 Proximal Humeral Fractures Treated with a Dedicated External Fixator with Follow-up Ranging from 2 to 12 Years
| العنوان: | Outcomes of 188 Proximal Humeral Fractures Treated with a Dedicated External Fixator with Follow-up Ranging from 2 to 12 Years |
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| المؤلفون: | Gabriele Pisanu, Enrico Bellato, Davide Blonna, Valentina Greco, Marco Assom, Roberto Rossi, Antonio Marmotti |
| المصدر: | Journal of Bone and Joint Surgery. 101:1654-1661 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, External fixator, Adolescent, External Fixators, Radiography, Bone Nails, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Fracture Fixation, Fracture fixation, Aged, Aged, 80 and over, Female, Follow-Up Studies, Health Status Indicators, Humans, Middle Aged, Retrospective Studies, Shoulder Fractures, Treatment Outcome, 80 and over, Medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, Surgical treatment, 030222 orthopedics, Shoulder Fracture, business.industry, Follow up studies, Retrospective cohort study, General Medicine, Surgery, Humeral fracture, business |
| الوصف: | The treatment of a displaced proximal humeral fracture is still a matter of controversy. Minimally invasive techniques are considered promising options. The purpose of this study was to report outcomes at medium to long-term follow-up after surgical treatment with pins stabilized with an external fixator.A total of 235 patients (average age, 64 years [95% confidence interval (CI), 62 to 65 years]) were treated with closed or open reduction and fixation with pins stabilized by an external fixator specifically designed for proximal humeral fractures. The pins were inserted using a "pins-crossing-fracture" or a "pins-bridging-fracture" technique. One hundred and eighty-eight patients had a minimum radiographic and clinical follow-up of 2 years. Outcomes were assessed using the Oxford Shoulder Score (OSS), the subjective shoulder value (SSV), a visual analog scale (VAS) for pain, and, for 155 patients, the Constant score.Eighty-one (43%) of the 188 patients had a 2-part fracture, 60 (32%) had a 3-part fracture, and 47 (25%) had a 4-part fracture. The reduction was performed with percutaneous maneuvers in 120 shoulders or a deltopectoral approach, in 68. The external fixator was applied using a "pins-crossing-fracture" technique in 133 shoulders and using a "pins-bridging-fracture" technique in 55. At last follow-up, mean clinical scores were as follows: OSS, 42.6 (95% CI, 42 to 44); SSV, 85.5 (95% CI, 83 to 88); and VAS for pain, 1 (95% CI, 0.7 to 1.2). The complication rate at 3 months was 16% (37 of 235). The most frequent complication was pin-track infection (19 of 235, 8%). A total of 50 patients had ≥1 complication (50 of 188, 27%) and 6 (3%) underwent revision surgery. More complications were observed with the "pins-crossing-fracture" technique.In our experience, the use of the external fixator has been a valuable option in the treatment of proximal humeral fractures. The complication and revision rates were acceptable. Most of the complications encountered were manageable without revision surgery.Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. |
| تدمد: | 1535-1386 0021-9355 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9f6863545ba4d4ad2f75526faa8138af https://doi.org/10.2106/jbjs.18.00734 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....9f6863545ba4d4ad2f75526faa8138af |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15351386 00219355 |
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