Abstract：
BACKGROUND:Locking plate fixation of proximal humeral fractures improves biomechanical stability. It has expanded the indications of traditional open reduction internal fixation and become increasingly common for treating unstable, displaced proximal humeral fractures. Despite improved stability it is unclear whether these improve function and if so for which patients. QUESTIONS/PURPOSES:We therefore determined patient function after a locked plating technique for the treatment of unstable proximal humeral fractures based on age, time, fracture pattern, and associated injures. PATIENTS AND METHODS:We retrospectively reviewed 66 patients with 69 proximal humeral fractures treated with a locked proximal humeral plating technique from 2002-2006 using prospectively gathered data. Function was measured using the Short Musculoskeletal Function Assessment (SMFA), Disability of the Arm, Shoulder, and Hand (DASH), and SF-36 at 6, 12, and 24 months. Fracture healing was determined radiographically and complication rates were determined from the medical records. RESULTS:At 2 years, DASH scores were 26.5 and 37.4 for isolated and polytrauma patients, respectively. For age differences, DASH scores were 33.1 and 28.9 for ages younger than 60 and 60 years old or older, respectively. At 2 years, SMFA scores were higher (worse) in older compared with younger patients. Function, but not bother continues to improve in younger patients up to 2 years. More severe fracture patterns performed worse in all SMFA indices at 2 years. Polytrauma patients consistently experienced worse mobility than isolated injury patients at each time interval. CONCLUSIONS:With locked plating of unstable proximal humeral fractures, older patients function as well as younger patients; improvement continues until 1 year postoperatively, the Neer fracture classification differentiates function, and polytrauma patients perform worse clinically. Long-term functional deficits persist. LEVEL OF EVIDENCE:Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Jones CB,Sietsema DL,Williams DKdoi
10.1007/s11999-011-1935-6subject
Has Abstractpub_date
2011-12-01 00:00:00pages
3307-16issue
12eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章abstract：:Records were reviewed for 96 patients who received distal femoral osteoarticular allografts to reconstruct femurs after wide resections of benign and malignant bone tumors. Thirteen of these were excluded from the study because of death or local recurrence. The mortality rate for all patients was 11%; for those with o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：:The techniques used in fixation of the femoral prosthesis in total hip replacement are often based on empiricism and raise questions about: venting the medullary canal with a catheter during the insertion of cement; the inclusion of blood into cement during insertion with possible deleterious effects; recementing a pr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197509000-00018
更新日期：1975-09-01 00:00:00
abstract：:Several lines of evidence suggest that the insulinlike growth factors play a role in fracture healing. They promote cell proliferation and matrix synthesis by chondrocytes and osteoblasts, the two cell types largely responsible for the formation of fracture callus. Circulating levels of insulinlike growth factor I and...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199810001-00031
更新日期：1998-10-01 00:00:00
abstract：UNLABELLED:There are many causes of total knee arthroplasty failure, and an accurate preoperative diagnosis is essential to optimize the results of revision surgery. We discuss our standard pre-operative evaluation routine and we retrospectively reviewed the last 295 patients who underwent revision total knee arthropla...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000218727.14097.d5
更新日期：2006-05-01 00:00:00
abstract：:An aggressive and recurrent pigmented villonodular synovitis of the knee occurred in a 47-year-old man. Magnetic resonance imaging was an excellent noninvasive diagnostic aid that completely outlined the extent of the synovitis and correlated well with surgical findings. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-11-01 00:00:00
abstract：BACKGROUND:The notion that neutral alignment is mandatory to assure long-term durability after TKA has been based mostly on short-film studies. However, this is challenged by recent long-film studies. QUESTIONS/PURPOSES:We conducted this long-film study to know (1) whether the risk of aseptic revision for nontraumatic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000012
更新日期：2018-02-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1097/00003086-200011000-00015
更新日期：2000-11-01 00:00:00
abstract：:The authors report the results of a consecutive series of 37 total condylar prostheses inserted between 1975 and 1977 in 31 osteoarthritic and six rheumatoid arthritic knees. Prostheses were inserted in 33 usually low-activity patients with an average age of 65 years. There was a five-year minimum follow-up period for...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-06-01 00:00:00
abstract：:This article presents four recent areas of research in biomechanics with clinical application. The first area describes quantification of the functional condition of the lower extremity using biomechanical parameters based on theoretical assumptions for a new mathematical model of walking. The second area describes th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-4839-7
更新日期：2016-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-11-01 00:00:00
abstract：:The medial collateral ligament is one of the most frequently injured ligaments in the knee. Although the medial collateral ligament is known to provide a primary restraint to valgus and external rotations, details regarding its precise mechanical function are unknown. In this study, strain in the medial collateral lig...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200110000-00031
更新日期：2001-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-06-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1999-06-01 00:00:00
abstract：:A case of an osteoid osteoma occurring in the cervical spine and presenting as scapular and arm pain has been described. Correct diagnosis was delayed for 2 years. Plain radiographs may fail to demonstrate a lesion in the spine. Radiographic evaluation, when osteoid osteoma is a possibility, should include bone scanni...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000229333.98781.56
更新日期：2006-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3241-y
更新日期：2014-06-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-12-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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更新日期：2000-08-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1397-2
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journal_title：Clinical orthopaedics and related research
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doi：10.1097/00003086-197501000-00006
更新日期：1975-01-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199604000-00019
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
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更新日期：2005-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
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更新日期：2014-08-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-12-01 00:00:00
