Fracture dislocations of the proximal humerus treated with open reduction and internal fixation: a systematic review

被引：14

作者：

Miltenberg, Benjamin ^{[1
]}

Masood, Raisa ^{[2
]}

Katsiaunis, Apostolos ^{[1
]}

Moverman, Michael A. ^{[2
]}

Puzzitiello, Richard N. ^{[2
]}

Pagani, Nicholas R. ^{[2
]}

Menendez, Mariano E. ^{[3
]}

Salzler, Matthew J. ^{[2
]}

Drager, Justin ^{[2
,4
]}

机构：

[1] Tufts Univ, Sch Med, Boston, MA USA

[2] Tufts Med Ctr, Dept Orthoped Surg, Boston, MA USA

[3] Rush Univ Med Ctr, Dept Orthoped Surg, Chicago, IL USA

[4] Tufts Med Ctr, 800 Washington St, Boston, MA 02111 USA

来源：

JOURNAL OF SHOULDER AND ELBOW SURGERY | 2022年 / 31卷 / 10期

关键词：

Fracture dislocation; ORIF; outcomes; complications; reoperation; AVN; TOTAL SHOULDER ARTHROPLASTY; RETROSPECTIVE ANALYSIS; AVASCULAR NECROSIS; LOCKED PLATE; OUTCOMES; HEMIARTHROPLASTY; CLASSIFICATION; OSTEONECROSIS; EPIDEMIOLOGY; MANAGEMENT;

D O I：

10.1016/j.jse.2022.04.018

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: The treatment of proximal humerus fracture dislocations can be challenging given the extensive injury to the proximal humeral anatomy and increased risk of devascularization of the humeral head often seen in these injuries. The purpose of this study is to undertake a systematic review of the literature on the functional outcomes, rate of revision, and short-and long-term complications for proximal humerus fracture dislocations treated with open reduction and internal fixation (ORIF).Methods: The PubMed and OVID Embase databases were queried for literature reporting on proximal humerus fracture dislocations treated with ORIF. Data including study design, patient demographics, functional outcomes, and complications were recorded.Results: Twelve studies including 294 patients with Neer type 2-, 3-, or 4-part proximal humerus fracture dislocations met the criteria for inclusion. The mean patient age was 53.4 years (19-89 years) with an average follow-up of 2.9 years (1.15-4.9 years). At the final follow-up, the mean Constant score was 73.2 (52-87.3) and the mean Disabilities of the Arm Shoulder and Hand score was 26.6 (17.5-32). Avascular necrosis was observed in 20.0% (0%-82.3%) and nonunion was observed in 3.0% (0%-7.7%) of patients. Conversion to arthroplasty was observed in 10.7% (5%-20%) and a total reoperation was observed in 35.6% (11.8%-89.1%) of patients in studies explicitly reporting these outcomes. In addition to conversion to arthroplasty, common causes of reoperation were revision ORIF (5.2%) and hardware removal (22.2%).Conclusion: Patients undergoing ORIF for proximal humerus fracture dislocations have reasonable functional outcomes but relatively high avascular necrosis and reoperation rates. This information can be used to counsel patients and set expectations about the potential for further surgeries.Level of evidence: Level IV; Systematic Review (c) 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

引用

页码：E480 / E489

页数：10

共 37 条

[11] Reverse total shoulder arthroplasty for failed open reduction and internal fixation of fractures of the proximal humerus [J].