Background： Technical aspects of the correct placement of medial support locking screws in the locking plate for proximal humerus fractures remain incompletely understood. This study was to evaluate the clinical rela...Background： Technical aspects of the correct placement of medial support locking screws in the locking plate for proximal humerus fractures remain incompletely understood. This study was to evaluate the clinical relationship between the number of medial support screws and the maintenance of fracture reduction after locked plating of proximal humerus fractures. Methods： We retrospectively evaluated 181 patients who had been surgically treated for proximal humeral fractures （PHFs） with a locking plate between September 2007 and June 2013. All cases were then subdivided into one of four groups as follows： 75 patients in the medial cortical support （MCS） group, 26 patients in the medial multiscrew support （MMSS） group, 29 patients in the medial single screw support （MSSS） group, and 51 patients in the 11o medial support （NMS） group. Clinical and radiographic evaluations included the Constant-Murley score （CM）, visual analogue scale （VAS）, complications, and revision surgeries. The neck-shaft angle （NSA） was measured in a true anteroposterior radiograph immediately postoperation and at final follow-up. One-way analysis of variance or KruskaI-Wallis test was used for statistical analysis of measurement data, and Chi-square test or Fisher＇s exact test was used for categorical data. Results： The mean postoperative NSAs were 133.46°± 6.01°, 132.39° ± 7.77°. 135.17° ± 10.15°, and 132.41° ± 7.16° in the MCS, MMSS, MSSS, and NMS groups, respectively, and no significant differences were found （F = 1.02, P= 0.387）. In the final follow-up, the NSAs were 132.79° ±6.02°, 130.19° ± 9.25°, 131.28° ± 12.85°, and 127.35° ± 8.50° in the MCS, MMSS, MSSS, and NMS groups, respectively （F = 4.40, P = 0.008）. There were marked differences in the NSA at the final follow-up between the MCS and NMS groups （P = 0.004）. The median （interquartile range [IQR]） NSA losses were 0.0° （0.0-1.0）°, 1.3° （0.0-3.1）°, 1.5° （ 1.0-5.2）°, and 4.0° （ 1.2 -7.展开更多
文摘Background： Technical aspects of the correct placement of medial support locking screws in the locking plate for proximal humerus fractures remain incompletely understood. This study was to evaluate the clinical relationship between the number of medial support screws and the maintenance of fracture reduction after locked plating of proximal humerus fractures. Methods： We retrospectively evaluated 181 patients who had been surgically treated for proximal humeral fractures （PHFs） with a locking plate between September 2007 and June 2013. All cases were then subdivided into one of four groups as follows： 75 patients in the medial cortical support （MCS） group, 26 patients in the medial multiscrew support （MMSS） group, 29 patients in the medial single screw support （MSSS） group, and 51 patients in the 11o medial support （NMS） group. Clinical and radiographic evaluations included the Constant-Murley score （CM）, visual analogue scale （VAS）, complications, and revision surgeries. The neck-shaft angle （NSA） was measured in a true anteroposterior radiograph immediately postoperation and at final follow-up. One-way analysis of variance or KruskaI-Wallis test was used for statistical analysis of measurement data, and Chi-square test or Fisher＇s exact test was used for categorical data. Results： The mean postoperative NSAs were 133.46°± 6.01°, 132.39° ± 7.77°. 135.17° ± 10.15°, and 132.41° ± 7.16° in the MCS, MMSS, MSSS, and NMS groups, respectively, and no significant differences were found （F = 1.02, P= 0.387）. In the final follow-up, the NSAs were 132.79° ±6.02°, 130.19° ± 9.25°, 131.28° ± 12.85°, and 127.35° ± 8.50° in the MCS, MMSS, MSSS, and NMS groups, respectively （F = 4.40, P = 0.008）. There were marked differences in the NSA at the final follow-up between the MCS and NMS groups （P = 0.004）. The median （interquartile range [IQR]） NSA losses were 0.0° （0.0-1.0）°, 1.3° （0.0-3.1）°, 1.5° （ 1.0-5.2）°, and 4.0° （ 1.2 -7.
