H Chen1, X Ji1, Y Gao1, L Zhang2, Q Zhang1, X Liang1, P Tang3. 1. The Department of Orthopaedic, The General Hospital of People's Liberation Army (301 hospital), 28 Fuxing road, Beijing 100853, PR China. 2. The Department of Orthopedic, KuanCheng Hospital, KuanCheng, Hebei, PR China. 3. The Department of Orthopaedic, The General Hospital of People's Liberation Army (301 hospital), 28 Fuxing road, Beijing 100853, PR China. Electronic address: tangpf301@163.com.
Abstract
OBJECTIVES: To compare the outcomes of intramedullary fibular allograft (IFA) with locking compression plates (LCPs) versus shoulder hemi-arthroplasty (HA) in osteoporotic four-part proximal humeral fracture (PHF). METHODS:Between January 2010 and December 2012, totally 60 cases with osteoporotic four-part PHF were enrolled in this study and were randomly separated into IFA and LCPsgroup and HA group (n=30). Additionally, surgery indexes for patients in the two groups, such as Constant-Murley score (CMS), the Disability of Arm, Shoulder and Hand (DASH) score, individual subject evaluation of the outcomes, plain X-ray, and computer tomography (CT) scanning were evaluated and compared. RESULTS:CMS, DASH score, activities of daily living (ADL), and range of motion (ROM) were statistically higher in the IFA and LCPs group than those in the HA group at the last follow-up, whereas the pain were obviously lower than that in the HA group. Besides, patients in the IFA and LCPs group had higher abduction, external rotation with elbow, strength, and satisfactory rating compared with HA group at the last follow-up. However, one case developed avascular necrosis (AVN), one case encountered screw perforation, and one case experienced varus displacement in the IFA and LCPs group, while there were 2, 4, and 2 cases suffered from superficial infection, shoulder stiffness, tuberosity migration in the HA group, respectively. CONCLUSION:IFA with LCP have an advantage in functional outcomes than shoulder HA. LEVEL OF EVIDENCE: Level II. Prospective cohort study.
RCT Entities:
OBJECTIVES: To compare the outcomes of intramedullary fibular allograft (IFA) with locking compression plates (LCPs) versus shoulder hemi-arthroplasty (HA) in osteoporotic four-part proximal humeral fracture (PHF). METHODS: Between January 2010 and December 2012, totally 60 cases with osteoporotic four-part PHF were enrolled in this study and were randomly separated into IFA and LCPs group and HA group (n=30). Additionally, surgery indexes for patients in the two groups, such as Constant-Murley score (CMS), the Disability of Arm, Shoulder and Hand (DASH) score, individual subject evaluation of the outcomes, plain X-ray, and computer tomography (CT) scanning were evaluated and compared. RESULTS: CMS, DASH score, activities of daily living (ADL), and range of motion (ROM) were statistically higher in the IFA and LCPs group than those in the HA group at the last follow-up, whereas the pain were obviously lower than that in the HA group. Besides, patients in the IFA and LCPs group had higher abduction, external rotation with elbow, strength, and satisfactory rating compared with HA group at the last follow-up. However, one case developed avascular necrosis (AVN), one case encountered screw perforation, and one case experienced varus displacement in the IFA and LCPs group, while there were 2, 4, and 2 cases suffered from superficial infection, shoulder stiffness, tuberosity migration in the HA group, respectively. CONCLUSION:IFA with LCP have an advantage in functional outcomes than shoulder HA. LEVEL OF EVIDENCE: Level II. Prospective cohort study.
Authors: Sebastian Orman; Amin Mohamadi; Joseph Serino; Jordan Murphy; Philip Hanna; Michael J Weaver; George Dyer; Ara Nazarian; Arvind von Keudell Journal: Shoulder Elbow Date: 2019-02-28
Authors: Sascha Halvachizadeh; Till Berk; Thomas Rauer; Christian Hierholzer; Roman Pfeifer; Hans-Christoph Pape; Florin Allemann Journal: PLoS One Date: 2020-04-09 Impact factor: 3.240