Does plate-screw density affect the functional outcomes in the treatment of proximal humerus fractures?
BACKGROUND: The aim of the study is to evaluate the relationship between plate-screw density (PSD), functional results, and complication rates in the treatment of proximal humerus fractures (PHFs) with proximal humerus locking anatomical plate (PHLAP). METHODS: Consecutive 43 patients (22 females an...
| Publicado en: | Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi Vol. 28; no. 6; pp. 824 - 832 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
KARE Publishing
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157200321&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157200321 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1306696X 84TB jtl: Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi issn: 1306696X maglogo: N pubinfo: dt: Jun2022 vid: 28 iid: 6 pid: 62027 pub: KARE Publishing artinfo: ui: 157200321 157200321 157200321 10.14744/tjtes.2021.99078 157200321 ppf: 824 ppct: 8 formats: tig: atl: Does plate-screw density affect the functional outcomes in the treatment of proximal humerus fractures? aug: au: Bayrak, Alkan Duramaz, Altuğ Koluman, Alican Kural, Cemal Ziroglu, Nezih Gözügül, Kadir Peker, Gökhan affil: Department of Orthopedics and Traumatology, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey sug: subj: Humeral Fractures Surgery Fracture Fixation Adverse Effects Internal Fixators Adverse Effects Bone Screws Adverse Effects Functional Assessment Postoperative Complications Treatment Outcomes Evaluation Prosthesis Design Human Surgical Patients Male Female Comparative Studies Clinical Assessment Tools Adult Middle Age Aged Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: The aim of the study is to evaluate the relationship between plate-screw density (PSD), functional results, and complication rates in the treatment of proximal humerus fractures (PHFs) with proximal humerus locking anatomical plate (PHLAP). METHODS: Consecutive 43 patients (22 females and 21 males) who underwent PHLAP for the treatment of PHF between 2010 and 2016 were evaluated. AO classifications were used for the classification of fractures. Based on the biomechanical stability theory of Erhardt et al., the patients were divided into two groups as <60% and >60% according to the number of screws fixed to the humeral head for the determination of PSD. The patients were divided into two groups as PSD <60% (n=21) and PSD>60% (n=22) according to the number of screws fixed to the humeral head for the determination of PSD. Functional results were evaluated using the Constant-Murley shoulder score (CMS). Radiological evaluation was performed with collodiaphyseal angle (CDA), varus-valgus angulation, avascular necrosis (AVN), and arthrosis. The groups were compared in terms of demographic characteristics, functional results, radiological scores, and complications. RESULTS: The mean age was 54.47±17.43 years and the mean follow-up time was 19.51±5.27 months. Although the CMS scores of patients with a PSD of over 60% were higher than those below 60%, the CMS score did not differ statistically. In groups, the mean CDA of the operated shoulder was significantly lower than that of the non-injured side (p=0.002). Eight patients had varus angulation, whereas two patients had humerus head AVN. No significant relationship was observed between PDS and functional scores, radiological results, and complications. CONCLUSION: Functional results of PSD >60% are higher than PSD <60% group but there is no statistical difference between groups according to functional, radiological results, and complications. AMAÇ: Çalışmanın amacı, proksimal humerus kırıklarının (PHK) proksimal humerus kilitli anatomik plak (PHKAP) ile tedavisinde plak-vida yoğunluğu (PVY), fonksiyonel sonuçlar ve komplikasyon oranları arasındaki ilişkiyi değerlendirmektir. GEREÇ VE YÖNTEM: Şubat 2010-Aralık 2016 tarihleri arasında PHK tedavisi için PHKAP uygulanan ardışık 43 hasta (K: 22, E: 21) değerlendirildi. Kırıkların sınıflandırılmasında AO sınıflandırması kullanıldı. Hastalar humerus başına uygulanan vida sayısına göre PVY <%60 ve PVY >%60 olarak iki gruba ayrıldı. Fonksiyonel sonuçlar Constant-Murley omuz skoru (CMS) kullanılarak değerlendirildi. Radyolojik değerlendirme kollodiafizer açı (KDA), varus-valgus açılanması, avasküler nekroz ve artroz ile yapıldı. Gruplar demografik özellikler, fonksiyonel sonuçlar, radyolojik skorlar ve komplikasyonlar açısından karşılaştırıldı. BULGULAR: Plak-vida yoğunluğu %60'ın üzerinde olan hastaların CMS skorları PVY'u %60'ın altındakilerden daha yüksek olmasına rağmen, CMS skorları arasında istatistiksel olarak farklılık görülmemiştir. Gruplarda, ameliyat edilen omzun ortalama KDA'sı yaralanmamış tarafa göre anlamlı olarak daha düşüktü (p=0.002). Sekiz hastada varus açılanması, iki hastada humerus başı avasküler nekrozu vardı. PVY ile fonksiyonel skorlar, radyolojik sonuçlar ve komplikasyonlar arasında anlamlı bir ilişki gözlenmedi. TARTIŞMA: Proksimal humerus kırıklarının cerrahi tedavisinde PVY, PHKAP uygulamasındaki fonksiyonel, radyolojik sonuçları ve komplikasyonları anlamlı olarak etkilememektedir. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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