- 作者：Per Olerud ; Leif Ahrengart ; Anita Sö ; derqvist ; Jenny Saving ; Jan Tidermark
- 关键词：Proximal humeral fractures ; internal fixation ; elderly ; functional outcome ; quality of life
- 刊名：Journal of Shoulder and Elbow Surgery
- 出版年：2010
- 出版时间：September 2010
- 年：2010
- 卷：19
- 期：6
- 页码：814-822
- 全文大小：219 K
Background
The aim of the study was to report the 2-year outcome after a displaced 2-part fracture of the proximal humerus in elderly patients treated with a locking plate, including an assessment of the health-related quality of life (HRQoL).Material and methods
We included 50 patients, mean age 75 (range, 55-93) years with 80 % women. The fracture inclusion criteria were a displacement of the shaft of >50 % of its width and/or >45° of angulation. Follow-up examinations were performed at 4, 12, and 24 months. The main outcome measures were the Constant and DASH scores and HRQoL according to the EQ-5D.
Results
Eight patients (16 % ) were re-operated upon during the study period. At the final follow-up the mean Constant score was 61 and the mean DASH score 32. The EQ-5D index score decreased from 0.86 before the fracture to 0.62 at 4 months. At 12 months the EQ-5D index score was 0.65 and at 24 months 0.68. The values at all follow-ups were significantly lower than before the fracture (P < .001 in all 3 comparisons).
Conclusion
Locking plates appear to be a good treatment alternative in elderly patients with a displaced 2-part fracture of the surgical neck of the proximal humerus with an acceptable complication rate and an acceptable functional outcome; however, rigorous attention has to be paid to avoid screw penetration. Despite the overall acceptable functional outcome, the patients reported a substantial negative effect upon their HRQoL.