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["Time-angle measurement" reduction evaluation technique and clinical evaluation of proximal humerus fracture]
1Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing 100044, China.
Objective:
To evaluate the functional outcome and the complication rate after open reduction and internal fixation of proximal humeral fractures with a "time-angle measurement" reduction evaluation technique, to assess the acceptance of the fracture reduction and to estimate the result of the sur-gery.
Methods:
Forty-six patients [mean age: (66.2±14.9) years] with an acute proximal humeral fracture were managed with open reduction and internal fixation with this reduction evaluation technique from January 2012 to December 2013. According to the Neer classification, there were 6 two- part fractures, 25 three-part fractures and 15 four-part fractures. The functional outcome was evaluated for each patient using the Constant-Murley score; radiographic evaluation was also conducted and complications were recorded. The postoperative shoulder function recovery and imaging findings were followed up to evaluate the guiding significance of this reduction evaluation technique in the clinical treatment of this kind of fracture.
Results:
In the study, 46 patients had been followed up for 13-36 months, and the average follow-up time was (23.5±7.3) months. All the patients achieved fracture healing 3 months after operation. The average head-shaft angle was (124±3.5) degrees. According to the Constant scoring system, 29 patients (63%) had excellent, 14 patients (30%) had good, and 3 patients (7%) had poor results. The most common complications were pain (7/65) and restricted movement of the shoulder (5/46). There were no cases of screw penetration, necrosis of humeral head, deep tissue infection, nonunion of fracture and axillary nerve injury after operation.
Conclusion:
For appropriate cases of displaced proximal humeral fractures, surgical treatment with application of "time-angle measurement" reduction evaluation technique that was introduced in the present study can lead to a good functional outcome, and the technique of reduction assessment should be regarded as a reasonable reference standard in the treatment of displaced proximal humerus fracture.
