上腕骨近位端骨折に対する骨接合術別の cutout 症例の検討

概要

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We investigated the clinical results of displaced proximal humeral fractures treated by plate, anterograde wiring, retrograde wiring and an intramedullary nail fixation. We evaluated the risk factors from the cases of complications occurred.(Materials and methods) one hundred and ten shoulders of 110 patients (26 males, 84 females, mean age 68 years old) underwent open surgery by pinning (28 cases), intramedullary fixation (62 cases) and plate fixation (20 cases). Fracture types were a 2 part A2 (44 cases), A3 (21 cases), 3 parts B1 (40 cases), and B2 (5 cases). From the clinical results we assessed the risk factors including age, fracture type and fixation method.Ten of 110 cases were cutout. The mean age was 68 years old(54-85). Six of 28 cases were pinning, 3 of 20 cases used a plate, and 2 cases of 62 the nail was cutout. In the type of fracture, 4 of 44 cases in A2, 5 of 21 cases in A3, 1 of 40 cases in B1, and 1 of 5 cases in B2 were cutout. The cutout risk was significantly increased in the pinning surgery, and the A3 fractures. In the cutout rate of pinning the risk of fractures was significantly high.Cutout risk was significantly increased in the type of unstable A3 fractures. Unstable A3 fractures were not suitable to pinning.
日本肩関節学会の論文