상완골 근위부 골절 치료에서 잠김 압박 금속판의 유용성

Usefulness of Locking Compression Plate (LCP) in Proximal Humerus Fracture

Purpose: To prove the efficacy of locking compression plate (LCP) in proximal humerus fracture. Materials and Methods: Forty four out of 48 patients who had proximal humerus fracture operation with LCP from November, 2004 to June, 2008 and available for follow up for more than 6 months were evaluated. Eighteen cases were male and 26 cases were female with mean age of 56 years (range 29-85 years). Cause of injury was traffic accident in 17 cases, slip down in 20 cases and fall down in 7 cases. Mean interval from injury to operation was 6.8 days (range 2-30 days) and mean operation time was 80. 5 minutes(range 40-130 minutes). Open reduction and internal fixation with LCP using deltopectoral approach was used in all cases. Postoperative clinical evaluation was done using Constant-Murley assessment and bone union and neck-shaft angle was checked using radiographic exam. Results: Bone union was achieved in 41 out of 44 cases at mean interval of 11.2 weeks(range 6-16 weeks). Mean neck-shaft angle was 129.7 degree (range 101-146) with more than 20 degree of angular deformation in 2 cases. For the complication, 2 cases of temporary axillary nerve injury, 1 case of nonunion，2 case of delayed unions with angulation, 2 case of ankylosis was observed. Conclusion: LCP can prevent reduction loss and minimize soft tissue injury which result in firm fixation and early immobilization. It seem to be very efficient in treating proximal humerus fracture in elderly.