Fracture site augmentation with calcium phosphate cement reduces screw penetration after open reduction–internal fixation of proximal humeral fractures

Egol, Kenneth A.; Sugi, Michelle T.; Ong, Crispin C; Montero, Nicole; Davidovitch, Roy I.; Zuckerman, Joseph D.

doi:10.1016/j.jse.2011.09.017

Cited by 93 publications

(68 citation statements)

References 19 publications

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“…1,6,20,21 Furthermore, the augmentation of head screws to compensate for low BMD has been shown to increase failure loads and stiffness after locking plate fixation of proximal humeral fractures. 5,10,14,16 Significant reductions in the complication rate with augmentation have yet to be proven. Furthermore, the effect of screw augmentation on motion at the bone-implant interface is unclear.…”

mentioning

confidence: 99%

Screw augmentation reduces motion at the bone-implant interface: a biomechanical study of locking plate fixation of proximal humeral fractures

Schliemann

Seifert

Roßlenbroich

et al. 2015

Journal of Shoulder and Elbow Surgery

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mentioning

confidence: 99%

Screw augmentation reduces motion at the bone-implant interface: a biomechanical study of locking plate fixation of proximal humeral fractures

Schliemann

Seifert

Roßlenbroich

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…In the case of valgus-displaced fractures, the cancellous bone is usually compacted in the epiphysis, leaving a void after anatomical reduction of the humeral head. Because centro-medullary pinning is low profile hardware, addition of bone substitute is mandatory to improve humeral head stability and reduce the risk of medialization of the greater tuberosity [4,22].…”

Section: Discussionmentioning

confidence: 99%

Kapandji pinning and tuberosities fixation of three- and four-part fractures of the proximal humerus

Bonnevialle

Ibnoulkatib

Mansat

et al. 2013

International Orthopaedics (SICOT)

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Purpose The Kapandji pinning was initially described for the treatment of surgical neck fractures of the humerus in young patients. The aim of our study was to evaluate functional and radiological outcomes of the Kapandji modified technique in displaced complex three-and four-part fractures.Methods From 2005 to 2009, 32 patients (23 three-part and nine four-part fractures) were included retrospectively. The mean age was 63 years old (range, 22-86), and the dominant shoulder was involved in 40 % of the cases. Results At a mean follow up of 25 months (12-72), the mean absolute Constant score achieved 68 points (35-98) and adjusted score 80 % (47-100). Patients had an average forward elevation of the shoulder of 132°(80°-180°), an average external rotation of 36°(0°-90°), and an average internal rotation to the level of L1 (sacrum to the level of T6). The older the patients were the worst was the active anterior elevation recovery (r=−0.3; p=0.01). Reduction and fixation of initial varus-displaced fractures was not as reliable as in valgus. In eight cases (25 %), K-wire migrations were observed and were correlated with age over 70 years old (p=0.001). Two partial osteolysis of the greater tuberosity and two avascular necrosis of the humeral head (one was associated with a non-union) were identified. Moreover, three patients developed adhesive capsulitis. Conclusion The Kapandji technique with fixation of tuberosities provides satisfactory results for the treatment of complex proximal fractures of the humerus. However, we do not recommend this technique for patients older than 70 years and in cases of varus displaced fractures.

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“…Die Augmentation der metaphysären Trümmerzone zeigte in vivo eine signifikante Reduktion der Schraubenpenetration und der sekundären Varisierung des Humeruskopfs [13].…”

Section: Biomechanikunclassified

“…Die hier gezeigten Daten unterstützen die in der Literatur bereits beschriebenen Untersuchungen, dass die Augmentation zu einer erhöhten Primärstabilität der Osteosynthese in vitro führt [6,13,20]. Berücksichtigt man die Korrelation zur Knochendichte, zeigt sich, dass die Augmentation eine reduzierte Trabekeldichte bis zu einem gewissen Grad kompensieren kann.…”

Section: Diskussionunclassified

Augmentationstechnik am proximalen Humerus

2015

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The augmentation of the screws in locked plating in a proximal humerus fracture model is effective in improving the primary stability in a cyclic varus bending test. The targeted augmentation of two particular screws in a region of low bone quality within the humeral head was almost as effective as four screws with twice the amount of bone cement. Screw augmentation combined with a knowledge of the local bone quality could be more effective in enhancing the primary stability of a proximal humerus locking plate because the effect of augmentation can be exploited more effectively limiting it to the degree required. The technique of augmentation is simple and can be applied in open and minimally invasive procedures. When the correct procedure is used, complications (cement leakage into the joint) can be avoided.

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Fracture site augmentation with calcium phosphate cement reduces screw penetration after open reduction–internal fixation of proximal humeral fractures

Cited by 93 publications

References 19 publications

Screw augmentation reduces motion at the bone-implant interface: a biomechanical study of locking plate fixation of proximal humeral fractures

Screw augmentation reduces motion at the bone-implant interface: a biomechanical study of locking plate fixation of proximal humeral fractures

Kapandji pinning and tuberosities fixation of three- and four-part fractures of the proximal humerus

Augmentationstechnik am proximalen Humerus

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