Techniques for Using a Novel Intramedullary Cage Technology for Fixation of Proximal Humeral Fractures

Paterson, Peter J.; Fulkerson, Eric; Palmer, Andrew K.

doi:10.15226/2374-6904/3/2/00149

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…The cage can be inserted in an anterograde or retrograde direction and both percutaneously or with a traditional deltopectoral approach. The surgical technique involves the reduction of the humeral head that can be kept in place with k-wire, but it typically interferes with the deployment of the cage [ 71 ]. When a satisfactory temporary reduction is obtained, a 2.0 mm k-wire is placed from the distal lateral cortex into the humeral head.…”

Section: Resultsmentioning

confidence: 99%

Synthetic Bone Substitutes and Mechanical Devices for the Augmentation of Osteoporotic Proximal Humeral Fractures: A Systematic Review of Clinical Studies

Marongiu

Verona

Cardoni

et al. 2020

JFB

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Background: Different augmentation techniques have been described in the literature in addition to the surgical treatment of proximal humeral fractures. The aim of this systematic review was to analyze the use of cements, bone substitutes, and other devices for the augmentation of proximal humeral fractures. Methods: A systematic review was conducted by using PubMed/MEDLINE, ISI Web of Knowledge, Cochrane Library, Scopus/EMBASE, and Google Scholar databases according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines over the years 1966 to 2019. The search term “humeral fracture proximal” was combined with “augmentation”; “polymethylmethacrylate, PMMA”; “cement”; “bone substitutes”; “hydroxyapatite”; “calcium phosphates”; “calcium sulfate”; “cell therapies”, and “tissue engineering” to find the literature relevant to the topic under review. Results: A total of 10 clinical studies considered eligible for the review, with a total of 308 patients, were included. Mean age at the time of injury was 68.8 years (range of 58–92). The most commonly described techniques were reinforcing the screw–bone interface with bone PMMA cement (three studies), filling the metaphyseal void with synthetic bone substitutes (five studies), and enhancing structural support with metallic devices (two studies). Conclusion: PMMA cementation could improve screw-tip fixation. Calcium phosphate and calcium sulfate injectable composites provided good biocompatibility, osteoconductivity, and lower mechanical failure rate when compared to non-augmented fractures. Mechanical devices currently have a limited role. However, the available evidence is provided mainly by level III to IV studies, and none of the proposed techniques have been sufficiently studied.

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Section: Resultsmentioning

confidence: 99%

Synthetic Bone Substitutes and Mechanical Devices for the Augmentation of Osteoporotic Proximal Humeral Fractures: A Systematic Review of Clinical Studies

Marongiu

Verona

Cardoni

et al. 2020

JFB

View full text Add to dashboard Cite

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Technique Spotlight

Goodnough¹,

DeBaun²,

Gardner³

2022

Skeletal Trauma of the Upper Extremity

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Intramedullary Cage Fixation for Proximal Humerus Fractures Has Low Reoperation Rates at 1 Year: Results of a Multicenter Study

Goodnough

Campbell

Githens

et al. 2020

Journal of Orthopaedic Trauma

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Objectives: To determine reoperation rates after treatment of a proximal humerus fracture with cage fixation. Design: Retrospective case series. Setting: Eleven U.S. hospitals. Patients: Fifty-two patients undergoing surgical treatment of proximal humerus fractures. Intervention: Open reduction and internal fixation of a proximal humerus fracture with a proximal humerus cage. Main Outcome Measurements: Reoperation rate at 1 year. Results: At a minimum follow-up of 1 year, reoperations occurred in 4/52 patients (7.7%). Avascular necrosis (2/41) occurred in 4.9% of patients. Conclusion: Standard locked plating remains an imperfect solution for proximal humerus fractures. Proximal humerus cage fixation had low rates of revision surgery at 1 year. Proximal humerus cage fixation may offer reduced rates of complication and reoperation when compared with conventional locked plating for the management of proximal humerus fractures. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Techniques for Using a Novel Intramedullary Cage Technology for Fixation of Proximal Humeral Fractures

Cited by 3 publications

References 29 publications

Synthetic Bone Substitutes and Mechanical Devices for the Augmentation of Osteoporotic Proximal Humeral Fractures: A Systematic Review of Clinical Studies

Synthetic Bone Substitutes and Mechanical Devices for the Augmentation of Osteoporotic Proximal Humeral Fractures: A Systematic Review of Clinical Studies

Technique Spotlight

Intramedullary Cage Fixation for Proximal Humerus Fractures Has Low Reoperation Rates at 1 Year: Results of a Multicenter Study

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