Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fracture

Vijayvargiya, Mayank

doi:10.7860/jcdr/2016/18122.8281

Cited by 40 publications

(62 citation statements)

References 61 publications

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“…In our study mean final constant score is 71.12 with a complication rate of 20% which was similar to other studies of proximal humerus fracture fixation by Moonet et al [15].No complication of avascular necrosis or plate breakage occurred in our study.…”

Section: Discussionsupporting

confidence: 80%

“…Whereas there is no significant difference in the functional outcome between 3 and 4 part fractures at 9 months which is also observed by Mayank et al [15] and Faraj et al [11]in their studies. But in a retrospective review of prospective collected data in 22 patients from Pakistan population using DASH score by A.M.Aliuddin et al [17] they found that there was no difference in outcome based on increasing comminution.…”

Section: Discussionsupporting

confidence: 64%

“…The reasons they quoted in their study is shorter surgical time and minimal soft tissue injury for 2 part fracture with PHILOS plate , which in turn have good healing with reduced postoperative pain resulting in early rehabilitation and good functional outcome. Also prospective studies by Mayank et al [15] in indian population and Bjorkenheim et al [16 ] in finnish population obtained better outcome in patients with 2-part fractures compared to the 3 and 4 part fractures based on constant scores using PHILOS plate. In a retrospective study by Faraj et al [11] involving 131 patients with more than two year follow up in netherland population conducted through telephonic interviews based on Visual analogue scale and Oxford shoulder score also showed similar results.…”

Section: Discussionmentioning

confidence: 99%

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Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fractures

Thirunarayanan¹,

Ramprasath²,

Amarnath³

et al. 2017

IOSR JDMS

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fractures

Thirunarayanan¹,

Ramprasath²,

Amarnath³

et al. 2017

IOSR JDMS

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“…The initial stability and screw fixation are essential because if they are compromised, the onset of head collapse commences. Implant loosening as a result of weak anchorage in poor bone quality is a still commonly reported complication with adverse effects on the recovery of a patient . In our study, the screw loosening event could be identified by the initial loss of stability before the onset of perforation accompanied by the head varus collapse.…”

Section: Discussionmentioning

confidence: 73%

Secondary Perforation Risk in Plate Osteosynthesis of Unstable Proximal Humerus Fractures: A Biomechanical Investigation of the Effect of Screw Length

Ciric

Mischler

Qawasmi

et al. 2019

Journal Orthopaedic Research

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Secondary perforation of screws into the joint surface is a commonly reported mechanical fixation failure mode in locked plating of proximal humerus fractures (PHF). This study investigated the influence that screws tip to joint distance (TJD) has on the biomechanical risk of secondary screw perforation and the stability of PHF. Ten pairs of cadaveric proximal humeri with a wide range of bone mineral density were used. Each specimen was osteotomized and instrumented with the PHILOS plate, simulating a highly unstable 3-part fracture. Bones were randomized into a long screw group (LSG) with 4 mm TJD, or a short screw group (SSG) with 8 mm TJD. A custom biomechanical setup was used to test the samples to failure cyclically with a constant valley load and an increasing ramp. The number of cycles to the initial screw loosening event was significantly higher for the LSG (mean ± standard deviation: 17,532 ± 6,458) compared with the SSG (11,102 ± 5,440) (p < 0.01). The mode of failure during testing was lateral-inferior displacement combined with varus collapse, with calcar screws perforating first. The number of cycles to failure event for LSG (27,849 ± 5,648) was not significantly different compared with SSG (28,782 ± 7,307) (p = 0.50). Screws that purchase closer to the joint had better initial stability and resistance against loosening. Placing longer screws, within limits dictated by the surgical guide, is expected to decrease the risk of secondary perforation failures in unstable PHF. These findings require clinical corroboration.

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“…19,20 But this was in contrast to the findings of Vijayvargiya et al study; the authors reported that most of the fractures were threepart (46.1%) followed by four-part (34.7%) and two-part (19.2%) PHF were reported to be least. 21 Similarly, Erasmo et al observed a higher number of three-part fractures (40), compared to four-part (35) and two-part (2) among a total number of 81 patients with 82 proximal humeral humerus fractures. 22 In our study, road traffic accident was the most common mode of injury (72%) followed by simple falls (28%).…”

Section: Discussionmentioning

confidence: 92%

Functional outcome in displaced proximal humeral fractures in adults treated by proximal humeral locking plates

et al. 2019

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Background: The management of proximal humerus fractures (PHF) is a challenging task to any surgeon. Study was conducted to evaluate the clinical and functional outcome of the proximal humeral internal locking system in fixation of displaced proximal humeral fractures.Methods: Study was conducted in the Department of Orthopedics, GSL Medical College. Informed written consent was taken from the study participants. All skeletally mature patients aged >18 years, presenting with displaced PHF according to Neer two, three and four part fracture were included in the study. Either deltopectoral or deltoid splitting approach was used for surgery, post-operative rehabilitation was started on day one.Results: Twenty-five patients with PHF were enrolled in the study; five-holed proximal humerus locking plate (PHLP) was used for 18 patients, eight-holed PHLP for 05 and three-holed, ten-holed PHLP for 01 for one each. The Constant-Murley score was significantly improved (p=0.000) over each successive follow-up period with the average improvement of around 19 scores between 1st and 2nd follow-up and around 15 score improvement between 2nd and 3rd follow-up.Conclusions: The proximal humeral locking plate is an adequate device for the fixation of displaced two-part, three-part and four-part PHF. Patient can regain good shoulder function, resume normal activities much earlier.

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Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fracture

Cited by 40 publications

References 61 publications

Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fractures

Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fractures

Secondary Perforation Risk in Plate Osteosynthesis of Unstable Proximal Humerus Fractures: A Biomechanical Investigation of the Effect of Screw Length

Functional outcome in displaced proximal humeral fractures in adults treated by proximal humeral locking plates

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