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Cement‐Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid‐ and Long‐Term Curative Efficacy

OBJECTIVES: The mid‐ and long‐term clinical outcomes of cement‐augmented screws in the treatment of osteoporotic proximal humeral fractures have rarely been reported. The aim of this study was to observe the mid‐ and long‐term efficacy of combined cement‐augmented screw fixation and PHILOS plating i...

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Autores principales: She, Rongfeng, Zhang, Bin, Jiang, Kundou, Yang, Shuaiqi, Zhang, Yi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694000/
https://www.ncbi.nlm.nih.gov/pubmed/37828796
http://dx.doi.org/10.1111/os.13887
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author She, Rongfeng
Zhang, Bin
Jiang, Kundou
Yang, Shuaiqi
Zhang, Yi
author_facet She, Rongfeng
Zhang, Bin
Jiang, Kundou
Yang, Shuaiqi
Zhang, Yi
author_sort She, Rongfeng
collection PubMed
description OBJECTIVES: The mid‐ and long‐term clinical outcomes of cement‐augmented screws in the treatment of osteoporotic proximal humeral fractures have rarely been reported. The aim of this study was to observe the mid‐ and long‐term efficacy of combined cement‐augmented screw fixation and PHILOS plating in the treatment of osteoporotic fractures of the proximal humerus. METHODS: This study retrospectively analyzed data from 19 patients with osteoporotic fractures of the proximal humerus who had undergone internal fixation at the Guizhou Provincial People's Hospital from February 2017 to May 2021. The cohort was comprised of six males and 13 females, aged 75–87 (mean age: 82.52 ± 1.24) years. According to the Neer classification, three, 12, and four patients had two‐part, three‐part, and four‐part fractures, respectively. All patients were treated with open reduction internal fixation with cement‐augmented screws and PHILOS plating. Time until fracture healing was recorded postoperatively. Patients were observed for postoperative complications, including humeral head necrosis, loosening or breaking of the augmented screws, screw perforation of the humeral head, and varus fracture displacement. Visual analog scale and Constant scores of the shoulder joint were compared 1, 3, 6, and 12 months after surgery. Scores at the most recent follow‐up were used to evaluate shoulder joint function. Measured data conforming to a normal distribution were expressed as mean ± SD. Analysis of variance or rank sum tests were used for intergroup comparisons. A value of p < 0.05 was considered significant. RESULTS: All 19 patients followed up for 1–4 (average: 2.13 ± 0.61) years. Fractures united in all cases, with a healing time of 8–14 (average: 10.25 ± 1.72) weeks. There were no cases of humeral head necrosis, screw loosening, fractures, or perforation of the humeral head. One patient had mild varus fracture displacement with a reduced neck‐shaft angle. There were significant differences in visual analog scale and Constant scores 1, 3, and 6 months after surgery (p < 0.05). The visual analog scale score was 0 at final follow‐up in all cases. The Constant score of the shoulder joint was excellent, good, fair, and poor in two, 12, four, and one case, respectively, yielding an excellent and good rate of 73.68%. CONCLUSIONS: Cement‐augmented screw fixation combined with PHILOS plating of osteoporotic proximal humeral fractures had good mid‐ and long‐term clinical efficacy. It should be considered a new option for fracture treatment in such patients.
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spelling pubmed-106940002023-12-05 Cement‐Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid‐ and Long‐Term Curative Efficacy She, Rongfeng Zhang, Bin Jiang, Kundou Yang, Shuaiqi Zhang, Yi Orthop Surg Clinical Articles OBJECTIVES: The mid‐ and long‐term clinical outcomes of cement‐augmented screws in the treatment of osteoporotic proximal humeral fractures have rarely been reported. The aim of this study was to observe the mid‐ and long‐term efficacy of combined cement‐augmented screw fixation and PHILOS plating in the treatment of osteoporotic fractures of the proximal humerus. METHODS: This study retrospectively analyzed data from 19 patients with osteoporotic fractures of the proximal humerus who had undergone internal fixation at the Guizhou Provincial People's Hospital from February 2017 to May 2021. The cohort was comprised of six males and 13 females, aged 75–87 (mean age: 82.52 ± 1.24) years. According to the Neer classification, three, 12, and four patients had two‐part, three‐part, and four‐part fractures, respectively. All patients were treated with open reduction internal fixation with cement‐augmented screws and PHILOS plating. Time until fracture healing was recorded postoperatively. Patients were observed for postoperative complications, including humeral head necrosis, loosening or breaking of the augmented screws, screw perforation of the humeral head, and varus fracture displacement. Visual analog scale and Constant scores of the shoulder joint were compared 1, 3, 6, and 12 months after surgery. Scores at the most recent follow‐up were used to evaluate shoulder joint function. Measured data conforming to a normal distribution were expressed as mean ± SD. Analysis of variance or rank sum tests were used for intergroup comparisons. A value of p < 0.05 was considered significant. RESULTS: All 19 patients followed up for 1–4 (average: 2.13 ± 0.61) years. Fractures united in all cases, with a healing time of 8–14 (average: 10.25 ± 1.72) weeks. There were no cases of humeral head necrosis, screw loosening, fractures, or perforation of the humeral head. One patient had mild varus fracture displacement with a reduced neck‐shaft angle. There were significant differences in visual analog scale and Constant scores 1, 3, and 6 months after surgery (p < 0.05). The visual analog scale score was 0 at final follow‐up in all cases. The Constant score of the shoulder joint was excellent, good, fair, and poor in two, 12, four, and one case, respectively, yielding an excellent and good rate of 73.68%. CONCLUSIONS: Cement‐augmented screw fixation combined with PHILOS plating of osteoporotic proximal humeral fractures had good mid‐ and long‐term clinical efficacy. It should be considered a new option for fracture treatment in such patients. John Wiley & Sons Australia, Ltd 2023-10-12 /pmc/articles/PMC10694000/ /pubmed/37828796 http://dx.doi.org/10.1111/os.13887 Text en © 2023 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Clinical Articles
She, Rongfeng
Zhang, Bin
Jiang, Kundou
Yang, Shuaiqi
Zhang, Yi
Cement‐Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid‐ and Long‐Term Curative Efficacy
title Cement‐Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid‐ and Long‐Term Curative Efficacy
title_full Cement‐Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid‐ and Long‐Term Curative Efficacy
title_fullStr Cement‐Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid‐ and Long‐Term Curative Efficacy
title_full_unstemmed Cement‐Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid‐ and Long‐Term Curative Efficacy
title_short Cement‐Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid‐ and Long‐Term Curative Efficacy
title_sort cement‐augmented screw fixation with philos plating for osteoporotic proximal humeral fractures: an observation of mid‐ and long‐term curative efficacy
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694000/
https://www.ncbi.nlm.nih.gov/pubmed/37828796
http://dx.doi.org/10.1111/os.13887
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