Treatment of the surgical neck fracture of the humerus with a novel external fixator in the elderly with osteoporosis: biomechanical analysis

Huang, Haijing

doi:10.1186/s12891-019-2599-8

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…The cement could provide strength which was between cancellous bone and cortical bone in compressive strength, bending modulus, and bending strength. [ 33 ] In biomechanical study of external fixator, Huang [ 31 ] found that the external fixator seemed to be superior to plate fixation in load bearing and resistance to torsional stress, the ultimate bearing capacity and load bearing were higher in the external fixator group (145.16 ± 17.42 N and 140 N, respectively) than plate group (120.21 ± 13.15 N and 69.63 ± 25.16–90.78 ± 17.18 N, respectively), and in the resistance to torsional stress, the external fixator’s torque fluctuated (within 1 Nm) more evenly distributed than plate’s torque (1–5 Nm), and external fixation provided the better rigidity. Li et al [ 30 ] also found that linking together the ends of fixation wires with external fixator could provide enough stability and could enhance the rotational stiffness of the construct.…”

Section: Discussionmentioning

confidence: 99%

Bone cemented K-wire fixation versus elastic stable intramedullary nailing fixation of paediatric proximal humerus fractures: A prospective cohort study

et al. 2023

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Background: The objective of this study is to compare the treatments of pediatric displaced proximal humerus fractures with external-fixation technique using the combination of K-wires and bone-cement versus close reduction and internal fixation technique using elastic stable intramedullary nail. Methods: From April 2016 to March 2020, 72 children with proximal humeral fractures were allocated to group A and 44 children with proximal humeral fractures were allocated to group B. Patients in group A were treated with bone-cemented K-wire fixation, and patients in group B were treated with elastic stable intramedullary nailing. The function of the upper limb was assessed using the Shortened Version of the Disabilities of the Arm, Shoulder and Hand questionnaire and Neer score. Patient satisfaction was assessed using the 10-cm visual analogue scale. Results: Bone healing was achieved in group A and B after a mean time of 6.1 ± 1.2 and 6.4 ± 1.1 weeks, respectively. The mean surgical time of groups was 33 ± 9 and 54 ± 12 minutes, respectively. The mean Quick Disabilities of the Arm, Shoulder and Hand questionnaire score of groups were 0.5 ± 1.4 and 0.7 ± 1.5, respectively. Based on Neer score, we obtained 69 excellent and 3 good results in group A, and 41 excellent and 3 good results in group B. There were significant differences regarding duration of operation, cost of treatment, and postoperative angle at bone healing ( P < .05). Conclusions: The external cemented K-wire fixation is a useful and reliable alternative technique for the treatment of severely displaced proximal humerus fractures in children. The technique is a minimally invasive procedure with minimal complications.

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Section: Discussionmentioning

confidence: 99%

Bone cemented K-wire fixation versus elastic stable intramedullary nailing fixation of paediatric proximal humerus fractures: A prospective cohort study

et al. 2023

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“…When surgical management of proximal humerus fractures is warranted, there are several surgical approaches available to achieving reduction and fixation of the fracture. Such methods include open reduction and internal fixation with screws and locking plates, intramedullary nailing, hemiarthroplasty, and even reverse total shoulder arthroplasty [2]. Each patient's medical comorbidities should be evaluated before considering if a patient is a candidate for surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Another comorbidity heavily correlated with proximal humerus fractures is osteoporosis [2]. Poor bone quality is a known predictor of intraoperative and postoperative complications; therefore, if a patient with known osteoporosis requires surgical intervention, careful considerations must be taken.…”

Section: Discussionmentioning

confidence: 99%

“…For alcohol use disorder, the challenges consist of preventing complications from withdrawal and poor wound healing [1]. Osteoporosis presents with further challenges of requiring more complicated fracture fixation in addition to the possibility of inappropriate bone quality leading to re-fracture or failure of the bone to incorporate into hardware [2,3]. Given these common comorbidities that often coincide with proximal fractures, orthopedic surgeons must be vigilant, both preoperatively and intraoperatively, when caring for such patient populations.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Management of Proximal Humerus Fractures in Patients With Common Injury-Specific Comorbidities

Callahan¹,

Batool²

2021

Cureus

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When evaluating a humeral neck fracture for surgical intervention, it is prudent to evaluate the patient for the common injury-specific comorbidities of alcoholism and osteoporosis, as the presence of either of these conditions, require additional considerations to prevent complications. This case presents a 63-year-old female who presented for evaluation after multiple falls. She was discharged from an outside facility one week prior with a left (nondominant extremity) humeral neck fracture. Her condition was complicated by alcohol use disorder with recent heavy alcohol use. On hospital stay day one, orthopedic surgery performed an initial assessment and deemed her fracture to be nonoperative due to medical comorbidities. On hospital stay day three, the patient requested a second opinion from orthopedic surgery due to continued increased pain and concern for the long-term function of her left upper extremity. The second opinion found that the fracture would be best managed by surgical intervention now that she had been medically optimized since admission. On hospital stay day five, she was taken to the operating room for planned percutaneous intramedullary nail placement with closed reduction of the fracture. Intraoperatively, the percutaneous procedure had to be converted to an open procedure due to the difficult nature of her osteoporotic bone in terms of performing a closed reduction. This case discusses the various methods for surgical management and guidelines for optimizing patients with the fracture-specific common comorbidities of alcohol use disorder and osteoporosis. The novelty of this case includes the rarity of a patient with both the major predisposing factors to proximal humerus fractures and includes a literature review of the latest recommendations for surgical management.

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“…However, studies investigating the morphometry of surgical neck, which is the most frequently fractured part, are almost nonexistent (10,15). While, neck fractures have been a subject to vast numbers of researches (16,17), its structural dispositions depending on the variants of sex and directional morphometry require further investigation. As the preceding studies usually endeavor to investigate humerus length comparisons between the male and female samples, they rarely pay attention to the surgical neck-based comparisons in measurements (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Collum Chirurgicum'un Morfometrik Değerlendirilmesi

Çeri¹

2021

Journal of Basic and Clinical Health Sciences

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fractures constitute approximately 5% of all fractures (2). Fractures of the proximal humerus account over 75% of all humeral fractures (3). In the last 5 years, the incidence of these fractures has increased by 15% (2). Surgical neck is a very frequently fractured area of the proximal humerus as the humerus begins to taper down at this point and is structurally weaker ABSTRACT Purpose: Surgical neck fractures have been a subject to vast numbers of researches, its structural dispositions depending on the variants of sex and directional morphometry requires further investigation. Therefore, we aimed to evaluate sex and side differences by using morphometric measurements of humerus and surgical neck. Methods:In order to achieve the above-mentioned objective, measurements were performed on dry humerus specimens from 60 male and 60 female origins. The circumference of surgical neck (SNC) and humerus length (HL) were measured in centimeter. After the completion of these measurements the area (SNA) of surgical neck was calculated and the data obtained was utilized to create two separate indexes. Results:The circumference of surgical neck differed significantly between the sexes (p=0.001), but not between the right-left sides (p=0.054). Although there was a significant difference between male and female HL on the right side (p=0.001), there was no significant difference on the left side (p=0.051). The highest mean value of the SNC in females (7.13 cm) was lower than the minimum value obtained in males (7.20 cm). The lowest mean value of the SNA in males (4.92 cm2) was higher than the maximum value obtained in females (4.84 cm2). There was a significant difference between sexes for both indexes (p<0.05). Conclusion:The morphometric data of this area may be utilized for forensic investigations, it may provide insight for the fracture treatments and solving clinical problems. We are opined that since the measurements of surgical neck varies in male and female samples, it may be an essentially important structure in determining sex of a given skeleton.

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Treatment of the surgical neck fracture of the humerus with a novel external fixator in the elderly with osteoporosis: biomechanical analysis

Cited by 6 publications

References 21 publications

Bone cemented K-wire fixation versus elastic stable intramedullary nailing fixation of paediatric proximal humerus fractures: A prospective cohort study

Bone cemented K-wire fixation versus elastic stable intramedullary nailing fixation of paediatric proximal humerus fractures: A prospective cohort study

Surgical Management of Proximal Humerus Fractures in Patients With Common Injury-Specific Comorbidities

Collum Chirurgicum'un Morfometrik Değerlendirilmesi

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