Nailing of three- and four-part fractures of the humeral head – Long-term results

Kloub, Martin; Holub, K; Poláková, Simona

doi:10.1016/j.injury.2013.10.038

Cited by 32 publications

(17 citation statements)

References 77 publications

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“…In patients treated with the 7-mm PHN, no cases of implant breakage during the procedure or follow-up were observed, in line with the outcomes of other studies [25,26] . Moreover, there were no cases of pseudoarthrosis, necrosis of the head or delays in consolidation.…”

Section: Discussionsupporting

confidence: 87%

Clinical Outcomes of the Phn Intramedullary Nail for Proximal Humeral Fractures

Ares

Sallent

Seijas

et al. 2017

International Journal of Orthopaedics

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AIM: Our aim was to analyze the functional outcomes of our initial experience in the treatment of proximal humeral fractures. The present technique lies in the implantation of an intramedullary nail with a spiral blade and guided interlocking distal bolts. METHODS: The series consisted of 5 patients (mean age 43.2 years old). Proximal humeral fractures included AO/ASIF type 11-B2 (3 cases) and type 11-A3 (2 cases). Follow-up was 15.7 months, observing absolute bone healing in all cases. RESULTS: Mean range of motion was 120˚ (SD 12). The mean central score on the Constant scale was 85.60 points (69-100) on the affected side, compared to the 97.60 points (100-88) obtained in the healthy side. The age-and sex-adjusted Constant score was 86.70 (SD 13). The physical component of the SF-12 indicated a moderate impact on health-related quality of life. CONCLUSION: Based on the favorable clinical and radiological outcome, the PHN nail appears to be an effective implant for attaining stability in displaced fractures, and this should be included as a possible form of treatment within the range of possible surgical repairs.

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Section: Discussionsupporting

confidence: 87%

Clinical Outcomes of the Phn Intramedullary Nail for Proximal Humeral Fractures

Ares

Sallent

Seijas

et al. 2017

International Journal of Orthopaedics

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“…Three studies additionally reported on outcomes following IMN of fracture dislocations [ 18 – 20 ], and three studies additionally reported on outcomes following IMN of combined proximal humerus and shaft fractures [ 11 , 21 , 22 ]. Only two of these studies were included, as explicit outcomes data for acute proximal humerus fractures could be elicited [ 11 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

Outcomes of intramedullary nailing for acute proximal humerus fractures: a systematic review

Wong

Newman

Gruson

2015

J Orthopaed Traumatol

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BackgroundWhile proximal humerus fractures remain common within the elderly population, the optimal treatment method remains controversial. Intramedullary nailing has been advocated as an effective and less invasive surgical technique. The purpose of this study is to elucidate the demographics, outcomes, and complications of intramedullary nailing for acute, displaced proximal humerus fractures.Materials and methodsMultiple computerized literature databases were used to perform a systematic review of English-language literature. Studies that met our stated criteria were further assessed for the requisite data, and when possible, similar outcome data were combined to generate frequency-weighted means.ResultsFourteen studies with 448 patients met our inclusion criteria. The frequency-weighted mean age was 64.3 years, and mean follow-up was 22.6 months. Females accounted for 71 % of the included patients. Three-part fractures (51 %) were most commonly treated. The overall frequency-weighted mean Constant score was 72.8, and American Shoulder and Elbow Surgeons (ASES) score was 84.3. Frequency-weighted mean forward elevation, abduction, extension, and external rotation were 137.3°, 138.4°, 33.8°, and 43.1°, respectively. The Constant score for two- and three-part fractures was significantly higher than for four-part fractures (p = 0.007 and p = 0.0009, respectively). The reoperation rate for two-, three-, and four-part fractures was 13.6, 17.4, and 63.2 %, respectively.ConclusionsIntramedullary nailing of acute, displaced two- and three-part proximal humerus fractures yields satisfactory clinical outcomes, although reoperation and complication rates remain high. Use of this implant for four-part fractures cannot be recommended until further clinical studies with larger patient numbers are available.Level of evidenceLevel IV, Systematic review.

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“…Small population studies show that intramedullary nailing can also achieve good postoperative results in 3- and 4-fragment fractures in the case of very good reconstruction of the fragments [15], [16].…”

Section: Discussionmentioning

confidence: 99%

Multifragmentary dislocated humeral head fracture—A case report of a successful head preserving treatment strategy despite delayed presentation

Bungartz

Matziolis

Rohe

et al. 2016

International Journal of Surgery Case Reports

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HighlightsCase report of multifragmentary and luxated humeral head fracture treated headpreserving despite delayed surgery (120 h).“Avoiding arthroplasty inspite of extrmely high risk of avascular necrosis due to compromised blood supply in luxation oft he humeral head.The headpreserving treatment showed excellent functional and radiologic results keeping a high “quality of life level”.Divergent from the recommended standard−treatment (trauma arthroplasty) of luxated humeral headsplit fractures in a “delayed situation” a head preserving option should be taken into consideration.

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Nailing of three- and four-part fractures of the humeral head – Long-term results

Cited by 32 publications

References 77 publications

Clinical Outcomes of the Phn Intramedullary Nail for Proximal Humeral Fractures

Clinical Outcomes of the Phn Intramedullary Nail for Proximal Humeral Fractures

Outcomes of intramedullary nailing for acute proximal humerus fractures: a systematic review

Multifragmentary dislocated humeral head fracture—A case report of a successful head preserving treatment strategy despite delayed presentation

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