上腕骨近位部骨折に対するＬｏｃｋｉｎｇ　Ｈｕｍｅｒａｌ　Ｓｐｏｏｎ　Ｐｌａｔｅ　の使用経験と問題点

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  • Treatment for the Proximal Humeral Fractures with Locking Humeral Spoon Plate

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Thirty-six patients (mean age, 64 years) with proximal humeral fractures were treated using Locking Humeral Spoon Plate (LHSP)(Synthes, Japan) from 2001 to 2003. The purpose of this study was to investigate the clinical results of this method. Using the AO/ASIF classification, 6 fractures were classified as 11-A2, 10 were A3, 12 were B1, 4 were B2, 1 was B3, 2 were C1 and 1 was C3.<br>The average postoperative flexion was 121.7°, the average abduction was 111.4°and the average external rotation was 44.8°. Thirty three patients healed without complication. One patient healed with varus deformity over 5°. In two patients, the plate cut out necessitated revision surgeries in which the LHSP was replaced with a longer plate, or humeral head prosthesis.<br>The LHSP maintained angular stability between plate and screws, and allowed exercise immediately after the operation. It is important to position the plate to avoid the medial side of the intertubercular sulcus, and to avoid impingement of the shoulder motion. It is possible to stabilize fractures of the 11-C3 type with the LHSP.<br>The LHSP internal fixation system offered us a new approache for treatment of these proximal humeral fractures.

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