抄録
The purpose of this study was to evaluate the clinical results of the osteosynthesis for proximal humeral fractures using the Targon PH nail™. 22 patients underwent osteosynthesis using the Targon PH nail from 2003 to 2005. 15 of these patients were followed up for more than 6 months (range, 6 to 37 months) after surgery. The average age at surgery was 69.7 years old. According to the AO classification, 3 fractures were classified as A2.1, 2 as A2.2, 3 as A3.1, 2 as B1.2, 1 as B3.1, 3 as C3.1, and 1 as C3.1. The clinical results were evaluated based on the JOA score and the UCLA score. Postoperative osteoarthritc changes were radiographically classified into 4 stages. All the patients obtained a bony fusion. The mean postoperative JOA and UCLA scores were 88.4 (range, 59.5 to 100) and 31.6 (range, 22 to 35), respectively. The mean range of shoulder flexion and external rotation was 136 degrees (range, 85 to 165) and 50 degrees (range, 20 to 80), respectively. Postoperative osteoarthritic changes were graded into early stage in 2 cases, advanced stage in 2 cases, and the end stage in 1 case. In 10 cases, no osteoarthritic change was seen. Metaphyseal comminution was associated with advanced or end stage osteoarthritis. Our results showed osteosynthesis using a Targon PH nail is a reliable treatment for proximal humeral fractures. It was very important to position the proximal end of the nail the just below the subchondral bone to insert multiple screws into the humeral head in the case of a metaphyseal comminution.
