Cho, Nam Su
(Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University College of Medicine)
,
Shim, Hee Seok
(Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University College of Medicine)
,
Lee, Sang Hyeon
(Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University College of Medicine)
,
Jeon, Jong Wook
(Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University College of Medicine)
,
Rhee, Yong Girl
(Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University College of Medicine)
Background: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. Methods: We enrolled 74 patients over the age of 60 years who received intern...
Background: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. Methods: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. Results: At the final follow-up, the mean Korean Showlder Society score and Constant scores were $88.96{\pm}12.1$ and $86.6{\pm}11.9$, respectively, in group A and $86.21{\pm}11.8$ and $85.3{\pm}11.7$, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was $1.6^{\circ}$ in group A and $4.8^{\circ}$ in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). Conclusions: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.
Background: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. Methods: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. Results: At the final follow-up, the mean Korean Showlder Society score and Constant scores were $88.96{\pm}12.1$ and $86.6{\pm}11.9$, respectively, in group A and $86.21{\pm}11.8$ and $85.3{\pm}11.7$, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was $1.6^{\circ}$ in group A and $4.8^{\circ}$ in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). Conclusions: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.
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문제 정의
The purpose of our study was to evaluate the functional and radiologic outcomes following a trans-cuff additive augmentation sutures in proximal humeral fractures stabilized by locking plates in elderly patients. In addition, we sought to investigate the clinical benefits of implementing additive augmentation sutures in these patients.
가설 설정
In addition, we sought to investigate the clinical benefits of implementing additive augmentation sutures in these patients. We hypothesize that the mechanical support provided by additive augmentation sutures through the rotator cuff is important for establishing a stable construct.
제안 방법
First, being retrospective in nature, our study has limitations related retrospective studies but we tried to minimize these limitations by conducting a retrospective analysis of the prospectively collected patients’ data.
Postoperative clinical evaluations were performed regularly on an outpatient basis (at 2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months postoperatively and at the last follow-up), and the results of the last follow-up were analyzed. Postoperative subjective pain score was measured using the visual analog scale (VAS).
데이터처리
An independent t-test was used to compare the VAS score, ROM, KSS, Constant score, and the radiological results between the two groups. Statistical significance was set to an α-level of 0.
이론/모형
Postoperative clinical evaluations were performed regularly on an outpatient basis (at 2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months postoperatively and at the last follow-up), and the results of the last follow-up were analyzed. Postoperative subjective pain score was measured using the visual analog scale (VAS). For postoperative shoulder range of motion (ROM), forward flexion, external rotation at the side, and internal rotation to the back were assessed.
For postoperative shoulder range of motion (ROM), forward flexion, external rotation at the side, and internal rotation to the back were assessed. The Korean Shoulder Society score (KSS) and Constant score22) were used for clinical assessment.
성능/효과
At the last follow-up, we found that the mean KSS and Constant scores were 88.96 ± 12.1 and 86.6 ± 11.9, respectively, in group A and 86.21 ± 11.8 and 85.3 ± 11.7, respectively, in group B. There were no statistically significant differences between the 2 groups (p=0.368, 0.271) (Table 2).
25) on 51 consecutive patients showed that proximal humerus fracture fixation using locking plates was associated with early complication and with their risk factors. In their study, a total of 12 patients (24%) had complications; screws penetration in 8 patients (16%), osteonecrosis in 2 (4%), early fixation failure in 2 (4%), and heterotopic ossification in 1 (2%). Similarly, when Clavert et al.
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