Minimally Invasive Fixation for Proximal Humeral Fracture: A Review on the use of T2 Proximal Humeral Nail: 以T2近端肱骨髓內釘為近端肱骨骨折病人進行微創內固定手術的回顧性研究

Objective and methodologyA retrospective review of the outcome of patients who had proximal humeral fracture treated with T2 Proximal Humeral Nail from January 2007 to March 2011 was conducted. The demographics, union rate, and complications were reviewed. The patient outcome was assessed with the American Shoulder and Elbow Surgeons (ASES) score and Constant-Murley score.ResultsThirty-two cases of traumatic proximal humeral fractures were included. The average follow-up period was 14.7 months. All fractures healed with an average of 3.97 months. The average forward flexion and lateral abduction of shoulder was 132° and 123°, respectively. The postoperative average Constant-Murley score was 67 (48-80) and ASES score was 82.9 (73-100). There was one case of avascular necrosis of humeral head. Six cases of minor screw complications required removal of screws later. No wound infection or neurovascular injury was found.Discussion and conclusionWith the proper surgical technique high union rate, good functional recovery, and low complication rate can be achieved by using T2 Proximal Humeral Nail in managing traumatic proximal humeral fracture.

中文摘要中文摘要 目標與方法 我們在2007年1月至2011年3 月進行了一個以T2近端肱骨髓內釘治療近端肱骨骨折病人的效果之回顧性研究。我們調查了患者的統計資料，骨折愈合率及併發症，利用Constant Murley評分 (Constant-Murley Score), 美國肩肘外科醫師會標準肩評估量表(American Shoulder and Elbow Surgeons Score)] 來評定病人的手術成效。 結果 我們的調查了32位患者，平均隨訪時間為14.7個月。所有骨折平均愈合期為3.97個月。肩膊的平均活動幅度分別為前屈132度及外展123度。術後的 平均Constant Murley評分 (Constant-Murley Score)為67 (48-80) 及美國肩肘外科醫師會標準肩評估量表（American Shoulder and Elbow Surgeons Score) 平均為82.9分 (73-100)。有1位病人出現肱骨頭壞死，6位出現輕微螺釘併發症，其後需進行移除鏍絲釘。在所有病人中並沒有發現任何傷口感染或血管神經損傷。 討論及總結 只要以適當的外科技術，使用近端肱骨髓內釘作治療近端肱骨骨折，是可以達到高的骨折愈合率，理想的肩膊功能恢愎及低併發症的效果。