Locking compression plate combined with medial buttress plate for the treatment of osteoporotic comminuted proximal humerus fractures / 中国骨伤

OBJECTIVE@#To explore clinical effect of lateral locking compression plate combined with medial buttress plate in treating osteoporotic comminuted fractures of proximal humerus.@*METHODS@#From May 2017 to December 2021, 12 patients with osteoporotic comminution of proximal humerus were treated by lateral locking compression plates combined with medial buttress plates, including 5 males and 7 females, aged from 55 to 78 years old, bone mineral density(BMD) less than -2.5 g/cm3, the time from injury to operation was from 2 to 6 days. According to Neer classification, 7 patients were type Ⅲ, 4 patients were type Ⅳ and 1 patient was type Ⅵ. Postoperative complications, fracture healing and internal fixation were observed and Constant-Murley score of shoulder joint was used to evaluate clinical effects at 6 months after operation.@*RESULTS@#Postoperative wound healed well at stage I. All patients were followed up from 6 to 18 months. Humeral head collapse and necrosis occurred in 1 patient and humeral head varus in 1 patient. No impact of shoulder joint, internal fixation loosening occurred. Constant-Murley score at 6 months ranged from 45 to 90 points, and 6 patients got excellent result, 3 good, and 3 poor.@*CONCLUSION@#Locking compression plate combined with medial buttress plate could effectively reconstruct medial humeral column support and enhance fracture stability, and receive satisfactory clinical results. However, no control group was established in this study, and function of shoulder joint has not been evaluated many times after operation, so it cannot dynamically reflect changes of shoulder joint function.

Surgical treatment of tibia plateau fractures with external fixator and the locking plate / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical effect of the treatment for complex fractures of the tibial plateau through the application of the external fixator and the locking plate.</p><p><b>METHODS</b>From Feb. 2006 to Oct. 2008,12 patients with tibial plateau fractures were treated with external fixator and locking plate included 8 males and 4 females with an average age of 38 years ranging from 23 to 59. According to Schatzker type, 7 cases were type V and 5 cases were type VI. Using an anteromedial incision and an anterolateral approach, the locking plate were fixed in the tibia lateral. The collapse and height lossing of tibial plateau was observed through X-ray film before and after operation. The function of knee joint was evaluated according to HSS scoring.</p><p><b>RESULTS</b>These patients were followed up for 4 to 18 months (means 9.79 months). Eleven cases had bone primary union,and 1 delayed union. No deep phlebothrombosis and osteofascial compartment syndrome occurened. The average healing time was 3.1 months. Between the preoperative and postoperative X-ray film there were no second stage depression fracture of the tibial plateau,postoperative reduction loss and bad alignment. The range of knee flexion was 90 degrees to 110 degrees. The HSS knee functional scoring was(75.50 +/- 10.01)scores after operation and (21.50 +/- 11.68) scores before operation.</p><p><b>CONCLUSION</b>The treatment with the external fixator and the locking plate for complex fractures of the tibial plateau could provid continuous stability of fixation,prevent the fracture from second stage displacement and the knee force line change, protect the soft-tissue around the knee, reduce the postoperative complications. The knee joint function is satisfied.</p>