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首页> 外文期刊>BMC Musculoskeletal Disorders >Operative treatment of 2-part surgical neck fractures of the proximal humerus (AO 11-A3) in the elderly: Cement augmented locking plate Philos? vs. proximal humerus nail MultiLoc?
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Operative treatment of 2-part surgical neck fractures of the proximal humerus (AO 11-A3) in the elderly: Cement augmented locking plate Philos? vs. proximal humerus nail MultiLoc?

机译：老年人肱骨近端（AO 11-A3）两部分手术性颈部骨折的手术治疗：水泥增强锁定钢板Philos？与肱骨近端钉MultiLoc？

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Background Proximal humeral fractures are with an incidence of 4–5?% the third most common fractures in the elderly. In 20?% of humeral fractures there is an indication for surgical treatment according to the modified Neer-Criteria. A secondary varus dislocation of the head fragment and cutting-out are the most common complications of angle stable locking plates in AO11-A3 fractures of the elderly. One possibility to increase the stability of the screw-bone-interface is the cement augmentation of the screw tips. A second is the use of a multiplanar angle stablentramedullary nail that might provide better biomechanical properties after fixation of 2-part-fractures. A comparison of these two treatment options augmented locking plate versus multiplanar angle stable locking nail in 2-part surgical neck fractures of the proximal humerus has not been carried out up to now. Methods/Design Forty patients (female/male, ≥60?years or female postmenopausal) with a 2-part-fracture of the proximal humerus (AO type 11-A3) will be randomized to either to augmented plate fixation group (PhilosAugment) or to multiplanar intramedullary nail group (MultiLoc). Outcome parameters are Disabilities of the Shoulder, Arm and Hand-Score (DASH) Constant Score (CS), American Shoulder and Elbow Score (ASES), Oxford Shoulder Score (OSS), Range of motion (ROM) and Short Form 36 (SF-36) after 3?weeks, 6?weeks, 3?months, 6?months, 12 and 24?months. Discussion Because of the lack of clinical studies that compare cement augmented locking plates with multiplanar humeral nail systems after 2-part surgical neck fractures of the proximal humerus, the decision of surgical method currently depends only on surgeons preference. Because only a randomized clinical trial (RCT) can sufficiently answer the question if one treatment option provides advantages compared to the other method we are planning to perform a RCT. Trial registration Clinical Trial ( NCT02609906 ), November 18, 2015, registered retrospectively.
机译：背景肱骨近端骨折的发生率为4–5％，是老年人中第三常见的骨折。根据改良的Neer标准，在20％的肱骨骨折中有手术治疗的适应症。在老年人的AO11-A3骨折中，继发性颅内碎片的内翻脱位和切开是角稳定锁定板的最常见并发症。增加螺钉-骨界面的稳定性的一种可能性是螺钉尖端的水泥增强。第二种是使用多平面角稳定角髓质钉，在固定两部分骨折后可能会提供更好的生物力学性能。到目前为止，还没有对这两种治疗方法在肱骨近端的两部分式手术性颈部骨折中使用增强锁定板与多平面角稳定锁定钉进行比较进行比较。方法/设计40例肱骨近端两部分骨折（AO型11-A3）的40例患者（女性/男性，≥60岁或女性绝经后）将被随机分为加强钢板固定组（PhilosAugment）或到多平面髓内钉组（MultiLoc）。结果参数是：肩膀，手臂和手部得分残缺（DASH）恒定分数（CS），美国肩膀和肘部得分（ASES），牛津肩膀得分（OSS），活动范围（ROM）和短版36（SF） -36）在3周，6周，3个月，6个月，12和24个月之后。讨论由于缺乏将肱骨近端两部分式手术性颈部骨折后，将水泥增强锁骨板与多平面肱骨钉系统进行比较的临床研究，目前，手术方法的决定仅取决于外科医生的偏好。因为只有一项随机临床试验（RCT）可以充分回答以下问题：一种治疗方案是否比另一种计划进行RCT的方法更具优势。试验注册临床试验（NCT02609906），2015年11月18日，进行了追溯注册。

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