Proximal Humerus Fractures - Current Treatment Options

Konrad, G.; Mehlhorn, Alexander T.; Kühle, Jan; Strohm, P. C.; Südkamp, Norbert P.

doi:10.55095/achot2008/078

Cited by 19 publications

(6 citation statements)

References 53 publications

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“…[18,19] Gradl et al [18] reported that the most common complications after plate applications were malunion and fracture displacement, and the most common complication after IMN application was proximal screw perforation. Konrad et al [20] reported that malunion and non-union were the most common complications regardless of plate or IMN application. In similar studies, it has been reported in the literature that the non-union rate is independent of implant selection.…”

Section: Discussionmentioning

confidence: 99%

Comparison of intramedullary nail and plate osteosynthesis in humerus surgical neck fracture

Şişman

Avcı

Poyraz

et al. 2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The aim of this study is to compare clinically and radiologically the plate osteosynthesis method and the intramedullary nail (IMN) method, which is currently used in the surgical treatment of surgical neck proximal humerus fractures (PHFs) in which there is no consensus METHODS: A total of 248 patients who underwent PHF between January 2013 and December 2017 were retrospectively reviewed. Sixty-two patients were included in the study. The results were clinically compared in terms of the amount of blood loss, operative time, and union time. Radiologically, it was compared in terms of intraoperative neck–shaft angle (NSA), final NSA, the American Shoulder and Elbow Surgeons (ASES), and Constant and Visual Analog Scale (VAS) scores. RESULTS: Two groups were formed: plate and IMN. The groups were similar in terms of age, sex, operation side, and follow-up time. There was no difference between the groups in terms of NSA, final NSA, ASES, Constant, and VAS scores. The amount of intraoperative blood loss, operative time, and union time was shorter in the IMN group. CONCLUSION: In surgical neck PHF surgery, plate and IMN are methods that show good clinical outcomes. According to this study, the advantages of the IMN method compared with plate osteosynthesis in Neer type II PHF treatment can be listed as less intraoperative blood loss, shorter operative time, and union time.

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Section: Discussionmentioning

confidence: 99%

Comparison of intramedullary nail and plate osteosynthesis in humerus surgical neck fracture

Şişman

Avcı

Poyraz

et al. 2023

Ulus Travma Acil Cerrahi Derg

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“…Zlomeniny horního konce kosti pažní jsou po zlomeninách proximálního femuru a distálního radia třetí nejčastější zlomeninou, přesto jejich počet uváděný různými autory kolísá od 5 do 10 % (7,17). Jejich incidence s věkem exponenciálně stoupá, což spolu se stárnutím populace a vzestupem zastoupení seniorů v posledních letech představuje do budoucna jistou medicínskou a ekonomickou zátěž (2,6,8,10,17,18,19). Jednoznačný léčebný koncept zejména pro dislokované víceúlomkové (tří-a čtyř-) zlomeniny chybí (16,27,29,34).…”

Section: úVodunclassified

“…Větší počet operačních technik, z nichž ani jedna nemá výraznější preferenci, je důkazem stále chybějícího konsenzu v léčbě (11). Nepříliš dobré výsledky a vysoký počet komplikací u dříve užívaných dlah, hlavně v osteoporotickém terénu, vedl k rozvoji úhlově stabilních implantátů, které mají výhodnější biomechanické vlastnosti a zároveň splňují kritéria miniinvazivity (1,13,18,24,33). Valná většina prací popisuje výsledky pouze jedné techniky a neporovnává je navzájem.…”

Section: Sběr Datunclassified

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Comparison of Functional Outcomes in Angle-Stable Osteosynthesis of Comminuted Fractures of the Proximal Humerus with Those in Percutaneous Kirschner-Wire Fixation. A Prospective Study of Mid-Term Results

Edelmann¹,

Obruba²,

Kopp³

et al. 2011

ACHOT

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“…LCP může být zásadní výhodou ve stabilitě osteosyntézy u kosti se sníženou minerální hustotou a tříštivou metafyzární zónou distálního humeru (12). Tyto vlastnosti LCP systému jsou prokázané i v jiných anatomických lokalitách (11,13,14,27,28). Perren ve svém referátu o kostním hojení popisuje lepší prokrvení oblasti zlomeniny při fixaci úhlově stabilními implantáty s lepším funkčním výsledkem a bezpečným hojením provázeným plnou obnovou funkce (20).…”

Section: Výsledkyunclassified

Treatment of Distal Humeral Fractures by Open Reduction and Internal LCP-DHP Fixation

Ch¹,

Matĕjka²,

Pavelka³

et al. 2010

ACHOT

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PURPOSE OF THE STUDYThe aim of this retrospective study was to evaluate the group of 27 patients with distal humeral fractures treated by the locking compression plate and distal humerus plate (LCP-DHP) system. MATERIALBetween January 2006 and June 2008, a total of 62 distal humeral fractures (61 patients) were treated in our department, of which 27 were managed by LCP-DHP. The group comprised 15 women (55.5 %) and 12 men (45.5 %), with an average age of 53.6 years (range, 18 to 84 years). METHODSConservative reduction and subsequent immobilization were done in all fractures. The surgical procedure was indicated within 24 hours of injury, with neurological deficit or an open fracture this was 6 hours. Access to the fracture was from a longitudinal dorsal incision with intra-articular osteotomy of the olecranon. The ulnar nerve was released and transposed. The fractures were reduced with an effort of maximal restoration of the articular surface, and then fixed with LCP-distal humerus plates. Antibiotic prophylaxis was administered and the wound was drained and a drain was inserted. The arm was immobilized in a plaster cast or a removable brace for 2 to 4 weeks, according to the fracture type. The patients had clinical and X-ray follow-up at 6 weeks, then at 3, 6 and 12 months after surgery. The evaluation was based on the Mayo elbow performance score (MEPS). RESULTSThe injury was caused by a fall in 24 patients (88.9 %), sustained in a car accident in two (7.4 %) and as the result of a gunshot in one patient (3.7 %).Multiple injuries to the musculoskeletal system were diagnosed in five patients (18.5 %). One patient with polytrauma after a fall from 6 metres suffered an ipsilater fracture of the distal femur (3.7 %). The two patients involved in car accidents (7.4 %) had injury to the contralateral acetabulum. Two patients (7.4 %) sustained distal radial fractures on the other side. Surgery was carried out within 10.5 hours (4 to 47) of injury on the average. The average hospital stay was 6.4 days (2 to 12). All 27 fractures were classified as AO type C fractures, of these seven were open fractures.Complete bony union was achieved at an average of 4 months, with a range of 3 to 9 months (in two patients 7.4 %) after surgery. The early post-operative complications included wound dehiscence due to superficial infection in two patients. In two patients early removal of the implants was indicated, and this was for ulnar nerve irritation and motion range restriction in one and deep infection in the other. No migration or failure of the implants was recorded.The average MEPS of the patient group was 91.6, which is in the range of excellent to very good results. DISCUSSIONThe group of our patients is by age, sex and AO type C fractures comparable with the groups of other authors. The number of complications is lower and the MEPS evaluation is comparable. Even when full anatomic reduction and stable fixation are achieved, the outcome may be compromised by heterotrophic ossification, joint rigidity or ulnar neuropathy, the...

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Proximal Humerus Fractures - Current Treatment Options

Cited by 19 publications

References 53 publications

Comparison of intramedullary nail and plate osteosynthesis in humerus surgical neck fracture

Comparison of intramedullary nail and plate osteosynthesis in humerus surgical neck fracture

Comparison of Functional Outcomes in Angle-Stable Osteosynthesis of Comminuted Fractures of the Proximal Humerus with Those in Percutaneous Kirschner-Wire Fixation. A Prospective Study of Mid-Term Results

Treatment of Distal Humeral Fractures by Open Reduction and Internal LCP-DHP Fixation

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