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Fibular strut allograft influences reduction and outcomes after locking plate fixation of comminuted proximal humeral fractures in elderly patients: a retrospective study
- Source :
- BMC Musculoskeletal Disorders, Vol 20, Iss 1, Pp 1-8 (2019), BMC Musculoskeletal Disorders
- Publication Year :
- 2019
- Publisher :
- BMC, 2019.
-
Abstract
- Background Proximal humeral fractures (PHFs) are the third most commonly occurring fractures in elderly patients. Most of these fractures can be treated with conservative methods, but the optimal surgical treatment strategy for unstable fractures in elderly patients remains controversial. This study aimed to compare the radiological and clinical outcomes between locking compression plate (LCP) fixation and LCP fixation with fibular allograft implantation for the treatment of comminuted PHFs. Methods We retrospectively reviewed 60 patients (mean age, 72.75 years) with closed 3- or 4-part fractures, and a minimum of 2 years of follow-up. Fracture reduction was quantitatively determined by humeral head height (HHH) and neck-shaft angle (NSA). The clinical outcome was evaluated by Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score. Result The average radiological changes were higher in the LCP group than in the locking plate with fibular allograft group (HHH of 4.16 mm vs 1.18 mm [p p = 0.024] and ASES score of 72.80 vs 78.64 [p = 0.022]). The FA group showed better forward elevation (p = 0.010) and abduction (p = 0.002); however, no significant differences were observed for shoulder external rotation or internal rotation. The number of complications was higher in the LCP group (28.57%) than in the FA group (1.2%) (p Conclusion For comminuted PHFs in elderly patients, LCP fixation combined with a fibular allograft is reasonable option to ensure satisfactory radiological and clinical outcomes. Trial registration ZDYJLY(2018)New-9. Name of registry: IEC for clinical Research of Zhongda Hospital, Affiliated to Southeast University. Date of registration: 2018-05-17.
- Subjects :
- Male
musculoskeletal diseases
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system
Sports medicine
medicine.medical_treatment
Elbow
Cohort Studies
03 medical and health sciences
Fixation (surgical)
Fracture Fixation, Internal
0302 clinical medicine
Fibular allograft
Rheumatology
Internal medicine
medicine
Humans
Transplantation, Homologous
Orthopedics and Sports Medicine
Proximal humeral fracture
Aged
Retrospective Studies
030222 orthopedics
Rehabilitation
Bone Transplantation
business.industry
Retrospective cohort study
030229 sport sciences
Middle Aged
Surgery
Elderly patients
medicine.anatomical_structure
surgical procedures, operative
Fibula
Radiological weapon
Orthopedic surgery
Shoulder Fractures
Female
lcsh:RC925-935
business
Bone Plates
Research Article
Locking plate
Subjects
Details
- Language :
- English
- ISSN :
- 14712474
- Volume :
- 20
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Musculoskeletal Disorders
- Accession number :
- edsair.doi.dedup.....78cf6524b41eefa74f6ac058a459ea65