ロッキングプレートを用いた上腕骨近位端骨折の術後成績
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<B>Background:</B> The purpose of this study was to evaluate the operative outcome of proximal humeral fractures using a locking proximal humerus plate.<BR><B>Methods:</B> Thirty-two patients who underwent open reduction and internal fixation (ORIF) between March 2007 and November 2010 were evaluated. There were 5 males and 27 females. The mean age was 70.1 years old (29-88) and the average follow-up period was 16.2 months (6-50). 17 patients had surgical neck 2-part fracture, 5 patients had 3-part fracture, 10 patients had valgus-impacted 3-part fracture.<BR><B>Results:</B> The postoperative mean active flexion: 130.3 degrees (60-170) , External Rotation/Internal Rotation: 44.4 degrees (0-75)/T12/L1 (T4-buttock). The average JOA score was 89.6 points (48-100). The average humeral head (HH) inclination angle was 131.1 degrees (102-160) immediately and 130.4 degrees(97-160) at final follow-up. Seven complications were encountered in 7 patients (21.9%) 2 months after operation. Four patients (12.5%) had screw perforation of the HH: three patients (9.4%) had HH necrosis. Two patients (6.3%) had displacement of greater tuberosity, and two patients (6.3%) had loss of HH inclination angle. There were no wound infections and neurological lesions. Five patients (15.6%) had a second operation.<BR><B>Discussion:</B> ORIF with the locking proximal humerus plate was a useful procedure. To minimize screw perforation and loss of correction, and to avoid forcible correction, a decision on suitable operative procedure and preventive fixation for the greater tuberosity were needed.
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