上腕骨近位端骨折に対するT2上腕骨ネイル近位骨折用を用いた手術治療経験

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The purpose of this study was to evaluate the surgical outcome for the osteosynthesis of proximal humeral fractures with T2 proximal humeral nails. We examined 18 shoulders in 18 patients with proximal humeral fracture treated using T2 proximal humeral nailing system from January 2005 to December 2006 with a minimum follow-up of three months after surgery. There were 7 males and 11 females, and the average age was 69.7 years old (32-91 years old). All patients were injured by a fall down. The fracture type was 2-part fracture in 15 patients and 3-part fracture in 3. Under general anesthesia fracture was reduced using fluoroscope and the nail was inserted from the proximal end of the humerus. Interlocking screws were inserted to both ends of the nail. The average operation time was 50.4 minutes (35-113 minutes). The range of motion exercise was started the day after the operation. Bony union, range of motion in flexion of shoulder joint, and postoperative complication were examined. The average follow-up period was 8.1 months (3-19 months). No redisplacement of the fracture was seen after surgery. A bony union was obtained on an average of 17.1 weeks (12-25 weeks). The mean postoperative range of motion was 107.8° in flexion (60°-170°). There were 2 cases with a back-out of proximal interlocking screw. Good stability was obtained with the T2 proximal humeral nailing system. The range of motion exercise was started immediately after surgery. However, the range of motion at the follow-up was not satisfactory. The postoperative exercise program should be reconsidered. It is necessary to improve the system for the prevention of the coming back-out of the proximal interlocking screw.
2008-06-30

上腕骨近位端骨折に対するT2上腕骨ネイル近位骨折用を用いた手術治療経験

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