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Revue de chirurgie orthopédique et traumatologique 100 (2014) 217

Disponible en ligne sur

ScienceDirectwww.sciencedirect.com

émoire original

esure radiographique de la perte de réduction dans les fracturesnstables de l’humérus proximal synthésées par plaque verrouillée�

adiological evaluation of reduction loss in unstable proximal humeral fracturesreated with locking plates

. Bai , Z.-G. Fu , T.-B. Wang , J.-H. Chen , P.-X. Zhang , D.-Y. Zhang , B.-G. Jiang ∗

epartment of orthopedics and traumatology, Peking university People’s hospital, Traffic medicine center, XiZhiMen South Avenue 11#, 100044 Beijing,hine

i n f o a r t i c l e

istorique de l’article :ccepté le 31 decembre 2013

eywords:roximal humerus fractureocking plateead-shaft angulationumeral head heightoss of reductionhoulder function

a b s t r a c t

Purpose. – The aim of this study was to radiologically evaluate the risk of reduction loss after locking platefixation of proximal humerus fractures.Method. – From September 2007 to April 2009, 71 patients (28 males, 43 females) with unstable proximalhumeral fracture were treated with open reduction and internal fixation by locking plate. The meanfollow-up time was 31.2 months (range: 26–47). The head-shaft angulation (HSA) and the humeral headheight (HHH) in true anteroposterior (AP) were recorded and compared over time. All complicationswere noted. Shoulder function was measured by the Constant score.Results. – Patients with �HSA > 10◦ (t = −2.740, P = 0.008) and �HHH > 5 mm (t = −2.55, P = 0.019) weremore likely to have impaired shoulder function. Varus collapse occurred most frequently in patients with

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initial reduction of HSA < 125 (� = 19.17, P < 0.001, Fisher’s exact test F < 0.001). Patients with > 5 mmHHH decrease were strongly associated with loss of reduction (�2 = 24.23, P < 0.001, F < 0.001).Conclusions. – Dynamic change of HSA > 10◦ and HHH > 5 mm were radiological factors that indicatedpoor shoulder function. Intra-operative HSA > 125◦ should be achieved to avoid reduction loss followinglocking plate fixation of proximal humerus fracture.Level of evidence. – Level IV.

© 2014 Published by Elsevier Masson SAS.

DOI de l’article original : http://dx.doi.org/10.1016/j.otsr.2013.12.024.� Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (www.sciencedirect.com)n utilisant le DOI ci-dessus.∗ Auteur correspondant.

Adresse e-mail : jiangbaoguo@vip.sina.com (B.-G. Jiang).

http://dx.doi.org/10.1016/j.rcot.2014.03.009877-0517/© 2014 Publie par Elsevier Masson SAS.