Mesure radiographique de la perte de réduction dans les fractures instables de l’humérus proximal synthésées par plaque verrouillée - 10/05/14
Radiological evaluation of reduction loss in unstable proximal humeral fractures treated with locking plates
Abstract |
Purpose |
The aim of this study was to radiologically evaluate the risk of reduction loss after locking plate fixation of proximal humerus fractures.
Method |
From September 2007 to April 2009, 71 patients (28 males, 43 females) with unstable proximal humeral fracture were treated with open reduction and internal fixation by locking plate. The mean follow-up time was 31.2months (range: 26–47). The head-shaft angulation (HSA) and the humeral head height (HHH) in true anteroposterior (AP) were recorded and compared over time. All complications were noted. Shoulder function was measured by the Constant score.
Results |
Patients with ΔHSA >10° (t=−2.740, P=0.008) and ΔHHH >5mm (t=−2.55, P=0.019) were more likely to have impaired shoulder function. Varus collapse occurred most frequently in patients with initial reduction of HSA <125° (χ2=19.17, P<0.001, Fisher's exact test F<0.001). Patients with >5mm HHH decrease were strongly associated with loss of reduction (χ2=24.23, P<0.001, F<0.001).
Conclusions |
Dynamic change of HSA>10° and HHH>5mm were radiological factors that indicated poor shoulder function. Intra-operative HSA>125° should be achieved to avoid reduction loss following locking plate fixation of proximal humerus fracture.
Level of evidence |
Level IV.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Proximal humerus fracture, Locking plate, Head-shaft angulation, Humeral head height, Loss of reduction, Shoulder function
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (www.sciencedirect.com/) en utilisant le DOI ci-dessus. |
Vol 100 - N° 3
P. 217 - maggio 2014 Ritorno al numero
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