上腕骨近位端骨折に対する角度可変式ロッキングプレートを用いた低侵襲手術後の変形癒合（内反変形 • 大結節高位）の検討

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Background: The purpose of this study was to evaluate the outcomes of minimally invasive plate osteosynthesis (MIPO) for proximal humeral fractures using variable polyaxial locking compression plates and screws. Methods: We evaluated a total of 20 shoulders (11 men and nine women; mean age, 53.3 years old; age range, 24-75 years) treated with MIPO. The average follow-up period was 14.1 (range, 6-32) months. Fracture type by AO classification was A in 9 cases, B in 9 cases, and C in 2 cases. Clinical evaluation included postoperative range of motion (ROM) of the shoulder and Japanese Orthopedic Association (JOA) score at final follow-up. X-rays (A-P view) were used to evaluate the proximal humeral deformities after union. Results: All cases showed bone union. There was only one complication during treatment in which humeral head necrosis on valgus impacted the fracture case. Postoperative elevated motion of the shoulder was 136.7 degrees and the JOA score was 85.0 points. There were 6 cases (30%) of varus deformity, and 5 cases showed loss of head-shaft angle after surgery. More proximal humeral varus deformities were in type A fractures compared with other fracture types. Conclusion: The outcome of MIPO for proximal humeral fractures was satisfactory in all cases. However, proximal humeral deformities such as varus displacement in type A fractures which showed loss of head-shaft angle after surgery, were observed in some cases. MIPO should be carried out correctly and fixedly in order to obtain more satisfactory outcomes and to avoid such deformities.

上腕骨近位端骨折に対する角度可変式ロッキングプレートを用いた低侵襲手術後の変形癒合（内反変形 • 大結節高位）の検討

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