Outcomes following fixation for proximal humeral fractures

Antonios, Tony; Bakti, Nik; Nzeako, Obinna; Mohanlal, P; Singh, Bijayendra

doi:10.1016/j.jcot.2019.01.029

Cited by 8 publications

(4 citation statements)

References 47 publications

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“…A variety of surgical options can be employed, including closed reduction and percutaneous fixation, closed or open reduction and internal fixation [ 7 ], and arthroplasty [ 3 ]. Non-operative treatment is generally accepted for undisplaced or minimally displaced PHFs, or for displaced fractures in the elderly with low functional demands or who are not cleared for surgery [ 3 , 4 , 8 ]. The most appropriate treatment for complex PHFs (cPHFs) in the elderly is still a topic of debate, as concomitant osteoporosis and significant comminution prevent the achievement of stable fixation, so they may benefit from arthroplasty rather than osteosynthesis [ 2 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

Troiano,

Peri,

Calò

et al. 2023

J Orthop Traumatol

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Background Complex proximal humeral fractures (cPHFs) represent an important public health concern, and reverse shoulder arthroplasty (RSA) has emerged as a feasible treatment option in the elderly with high functional demands. Recent studies have shown that tuberosity healing leads to better clinical outcomes and an improved range of motion. However, the best surgical technique for the management of the tuberosities is still a topic of debate. The purpose of this retrospective observational study is to report the radiographic and clinical outcomes of a consecutive series of patients who underwent RSA for cPHFs using a novel “7 sutures and 8 knots” technique. Materials and methods A consecutive series of 32 patients (33 shoulders) were treated with this technique by a single surgeon from January 2017 to September 2021. Results at a minimum follow-up of 12 months and a mean ± SD follow-up of 35.9 ± 16.2 (range 12–64) months are reported. Results The tuberosity union rate was 87.9% (29 out of 33 shoulders), the mean Constant score was 66.7 ± 20.5 (range 29–100) points, and the mean DASH score was 33.4 ± 22.6 (range 2–85) points. Conclusions The “7 sutures and 8 knots” technique, which relies on three sutures around the implant and five bridging sutures between the tuberosities, is a relatively simple procedure which provides a reliable means for anatomic restoration of the tuberosities and allows functional recovery of the shoulder in elderly patients with cPHFs treated with RSA. Level of evidence: IV; retrospective atudy. Trial registration: At our institution, no institutional review board nor ethical committee approval is necessary for retrospective studies.

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Section: Introductionmentioning

confidence: 99%

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

Troiano,

Peri,

Calò

et al. 2023

J Orthop Traumatol

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“…Наиболее часто используемыми методами фиксации переломов ПОПК являются накостный остеосинтез блокирующей пластиной и интрамедуллярный остеосинтез стержнем [13,14].…”

Section: Introductionunclassified

Modern Implants for Osteosynthesis Fractures of the Proximal Humerus

Yergali,

Aueshan,

Zhasulan

et al. 2023

JTO

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Treatment of patients with fractures of the proximal humerus remains an urgent problem of modern traumatology and orthopedics. The most commonly used methods of fracture fixation are extramedullary fixation with a locking plate and intramedullary fixation with a rod. However, as many experts report, osteosynthesis with a blocking plate often causes the development of aseptic necrosis of the head of the humerus, pseudoarthrosis, and screw migration. The results of intramedullary, including antegrade, osteosynthesis with nails of the first and second generations showed a high level of complications, especially iatrogenic damage to the tendons of the rotator cuff of the shoulder. In this regard, promising studies make it possible to improve implants for both external and intraosseous osteosynthesis of complex fractures of the proximal humerus.The purpose of this work is to study implants for extramedullary and intramedullary osteosynthesis of tracheal fractures.Analysis of literature sources indexed in the Scopus, PubMed, Google Scholar, Lilacs and Cuiden databases, devoted to the study of the method of extramedullary and intramedullary osteosynthesis of tracheal fractures.In the literature review, we structured implants for intramedullary osteosynthesis of fractures of the proximal humerus based on their advantages and fixation properties.Conclusions. The problem of choosing the optimal implant for fixing fractures of a given localization will continue to be discussed among specialists. Further study of this issue will allow researchers to identify the main problems in the treatment of fractures and note promising areas of surgical treatment of such injuries.Key words: fracture, humerus, osteosynthesis, extramedullary osteosynthesis, intramedullary osteosynthesis, metal structure

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“…The most frequently used treatment options are the locking plate and the antegrade nailing. ( 5 Complications associated with locking plates include necrosis of the humeral head (35%), screw cut-out (57%) and pseudarthrosis (13%). 6 Osteosynthesis, with antegrade nailing, emerged as a viable option in the treatment for proximal humerus fractures, with the advantage of lower soft tissue dissection and superiority over plates in biomechanical studies for fractures in two parts of the surgical neck.…”

Section: Introductionmentioning

confidence: 99%

Antegrade Nailing Versus Locking Plate of 2-and 3-Part Proximal Humerus Fractures

et al. 2022

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Objective: To evaluate and compare the proportions of complications and radiographic findings of osteosynthesis of 2- and 3-part proximal humerus fractures with two methods of treatment: third-generation antegrade nailing and locking plate. Methods: 46 patients with a mean age of 58.9 ± 16.6 years between January 2020 and January 2021 were evaluated. In sixteen cases (34.8%), antegrade nailing was used, and in thirty cases (65, 2%), a locking proximal humerus plate. The method used included the rate of complications with a minimum follow-up of 6 months after surgery and radiographic evaluation. Results: There was no difference between the groups regarding the proportion of complications (nail group 18.8%, plate group 13.3%; p = 0.681). The nail group had less residual varus loss (cervicodiaphyseal angle nail group with 132.1º ± 2.3º, plate group 123.8º ± 10.1º; p < 0.001). In the plate group, women had the lowest value (1.43 ± 0.22) of the deltoid tuberosity index (DTI) compared to men (1.58 ± 0.11) (p = 0.022). Conclusion: Osteosynthesis, with a locking plate and antegrade nailing, did not show differences in the proportion of complications. The nail group had less change in the postoperative cervicodiaphyseal angle, however, there were two serious complications with screw cut-out and varus deviation, requiring surgical reapproach. Level of Evidence II, Retrospective Observational Study.

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Outcomes following fixation for proximal humeral fractures

Cited by 8 publications

References 47 publications

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

Modern Implants for Osteosynthesis Fractures of the Proximal Humerus

Antegrade Nailing Versus Locking Plate of 2-and 3-Part Proximal Humerus Fractures

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