Outcomes of open reduction and internal fixation of proximal humerus fracture dislocations.

Autor: Padegimas EM; Connecticut Orthopaedic Specialists, Connecticut Orthopaedic Institute at Midstate Medical Center, Hamden, CT, USA. Electronic address: padegimase@gmail.com., Nicholson TA; The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospitals, Philadelphia, PA, USA., Chang G; The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospitals, Philadelphia, PA, USA., Hebert-Davies J; Harborview Medical Center, University of Washington, Seattle, WA, USA., Namdari S; The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2021 Oct; Vol. 30 (10), pp. 2331-2335. Date of Electronic Publication: 2021 Feb 18.
DOI: 10.1016/j.jse.2021.01.025
Abstrakt: Introduction: Proximal humeral fracture with associated glenohumeral dislocation (PHFD) is a challenging clinical problem. Outcomes of open reduction and internal fixation (ORIF) of these injuries have not been widely reported. The purpose of this analysis is to report our experience with ORIF of PHFD.
Methods: A retrospective review of our 2 institutions' shoulder surgery databases was conducted to identify all PHFDs that were treated with ORIF from 2008 through 2017. Radiographs were reviewed for fracture healing by 12 weeks postoperatively. All reoperations were recorded. Patient-reported outcomes using Simple Shoulder Test (SST) and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) scores at a minimum 2-year follow-up were recorded.
Results: There were 20 PHFDs identified: they were 50% male, 55.8 ± 10.3 years old (range 31.3-66.3), and had a body mass index of 29.3 ± 8.2 (15.2-47.8). Seven (35%) patients experienced varus collapse, nonunion, or avascular necrosis and 6 (30%) patients underwent reoperation. Of the 17 patients who did not go on to revision or arthroplasty, 14 (82.3%) had patient-reported outcomes at a mean follow-up of 4.9 ± 2.2 years (2.3-8.8). These patients had an average SST 8.0±4.0 yes responses (0-12) and ASES scores of 71.6 ± 20.4 (20.2-94.9).
Conclusion: ORIF of PHFD carries a high rate of reoperation. In patients who achieve healing, functional scores are satisfactory. This information is important for proper patient counseling prior to surgery.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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