Detaillierte Beitrags-Information
| Beitragstitel | Outcome after long locking plate osteosynthesis of complex humeral shaft fractures. |
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| Beitragscode | P006 |
| Autoren | |
| Präsentationsform | Poster |
| Themengebiete |
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| Abstract |
Introduction Humeral shaft fractures account for up to 5% of all fractures, but complex form of those fractures (type AO B or higher) are relatively rare. Recent trend towards a minimally invasive plate osteosynthesis (MIPO) potentially offers the same union rate as open reduction and internal fixation (ORIF) but less complications. The aim of our study is to show that, according to our experience, the treatment of complex humeral fractures via open reduction and internal fixation with a long pre-contoured plate (long PHILOS) is a viable option with low morbidity of the open approach, few compilations, high union rate and good clinical outcome. Methods We performed a retrospective study of complex humeral shaft fractures treated in our institution between June/2011 and December/2017. We could identify and include 27 consecutive patients treated with a long PHILOS plate (7 male, 20 female; average age: 65 years) that had complete records to at least 1 year follow-up. Complications and fracture healing were evaluated, as well as clinical outcome and quality of life (DASH score and EQ-5) at last follow-up. Results Average postoperative follow-up was 20.5 (SD ± 11) months. Radiological examination could positively confirm fracture healing on average at 12.7 (SD ± 3) months. Average DASH score was 35 (SD ± 15.83). The EQ-5 Mobility score was 1.58 (SD ±0.81), EQ-5 Self-Care 1.23 (SD ±0.59), and EQ-5 VAS 86 (SD ±9.17). Complications included one secondary fracture dislocation, two postoperative radial nerve palsies, and two implant failures (18.5%). Conclusion ORIF with long PHILOS plate is a safe and effective option for the treatment of complex humeral shaft fractures, offering good functional recovery and low complication rate. Compared to closed operative treatment options (MIPO, nailing) ORIF and long PHILOS plate had no increased morbidity attributed to relatively long open surgical approach. In our series, radial nerve palsy could not be completely avoided, which accentuates the importance of precise surgical technique. |