Treatment of Two- and Three-Part Fracture of Proximal Humerus using LCP

Shin, Sung Il; Song, Kyung Won; Lee, Jin Young; Lee, Seung Yong; Kim, Gab Rae; Hyun, Yoon Suk; Park, Deok Yong

doi:10.5397/cise.2007.10.2.204

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…4,5) Most humeral fractures occur in the middle third or at the distal border of the humerus, which is where a configuration change occurs from a single circular cross-section to the tip of triangular cross-sections. This has meant that stan-A B C dard plate fixation procedures must position the plates over the relatively flat anterolateral face of the humerus, followed by contouring of the plate through bending or rotation so that the plate is shaped along the bone surface.…”

Section: Discussionmentioning

confidence: 99%

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

Lee¹,

Choi²,

Kim³

et al. 2016

Clinics in Shoulder and Elbow

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Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for frac tures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single inci sion. Postoperatively, we mea sured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an aver age 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final followup (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of seg mental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation. (Clin Shoulder Elbow 2016;19(4):223-228)

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Section: Discussionmentioning

confidence: 99%

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

Lee¹,

Choi²,

Kim³

et al. 2016

Clinics in Shoulder and Elbow

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“…To broaden its application to diverse clinical cases and prove its effectiveness through quantitative analysis, this surgical procedure has been vigorously investigated [9][10][11] with a focus on the design of the LCP and on the appropriate number of screws for preventing bone loss [12][13][14][15][16]. The existing literature shows that placement of a calcar screw in the lower part of the proximal humerus can help achieve safe and stable fixation; using calcar screws particularly make sense in case of a fracture in which there is unstable medial support of the proximal humerus caused by the varus of humeral head.…”

Section: Introductionmentioning

confidence: 99%

Effect of Calcar Screw in Locking Compression Plate System for Osteoporotic Proximal Humerus Fracture: A Finite Element Analysis Study

Lee

Kim

et al. 2022

BioMed Research International

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This study proposes a finite element analysis (FEA) model for complex fractures at the osteoporotic proximal humerus and investigates the relevance of using a calcar screw in surgical treatments using this model. Two types of three-dimensional (3D) fracture models of patients with osteoporotic humerus were constructed reflecting the mechanical properties of the osteoporotic humerus, such as the Young's modulus and Poisson's ratio, and two load conditions mimicking the clinical environment were applied for simulation. Using the 3D models and the conditions, the FEA software calculated the concentration and distribution of stresses developing in the humerus, locking compression plate (LCP), and screws. Then, we evaluated and predicted the fixed state of a LCP system depending on whether the maximum stress value exceeded tensile strength. When axial force was applied, insertion of the calcar screw led to significant reduction of stress applied on screws in the fracture model having a medial gap by approximately 61%, from 913.20 MPa to 351.84 MPa. Based on the results, it was clearly confirmed that using of calcar screws improved the stability of a three-part fractures and simultaneously reinforced medial support.

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“…수술적 치료 방법으로 골 봉합법, K-강선 고정술 및 긴장대 술식, 금속판 및 나사못 고정 술, 골수강 내 고정술 등의 다양한 방법들이 시도되고 있으나 6,7,19,22,27,33) , 아직 최선의 치료 방법에 대해서는 이 견이 많으며, 그 결과도 다양하게 보고되고 있다 24) . 그 중 잠김 금속판은 고식적인 금속판에 비해 골절편 의 혈액 공급을 보존할 수 있고, 초기 견고한 각 안정 성 및 회전 안정성을 얻을 수 있어 조기에 관절 운동을 가능하게 하는 장점이 있어 최근 임상적으로 많이 사용 되고 있다 11,32) . 이에 저자들은 상완골 근위부 골절에서 잠김 압박 금속판을 이용한 내고정술 후 그 임상적 및 방사선학적 결과를 평가해 보고자 하였다.…”

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Internal Fixation of Proximal Humerus Fracture with Locking Compression Plate

Park¹,

Park²,

Seo³

2009

The Journal of the Korean Shoulder and Elbow Society

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Purpose:We assessed the radiographic and clinical results of one surgeon's experience treating proximal humerus fractures with a locked proximal humeral plate. Materials and Methods: Twenty patients with unstable proximal humerus fractures were treated with a locking compression plate between February 2005 and September 2007. The average age of the patients was 60.6 years, and the average postoperative follow-up period was 22.3 months. The clinical results were evaluated using the Constant and DASH scores. The radiologic results were evaluated by the Paavolainen method, which measures the neck shaft angle and humeral head height. Results: At the last follow-up examination, the mean Constant score was 75.3 and 15 cases (75%) had excellent or good results; the mean DASH score was 16.4. The mean neck shaft angle was 137.1。 , and 19 cases (95%) had good results by the Paavolainen method. There was one delayed union, malunion, and screw loosening. Conclusion:The patients treated with a locking compression plate had relatively good clinical and radiologic results, and a low complication rate. Moreover, the patients could exercise earlier due to good reduction and initial stability. Treatment of unstable proximal humerus fractures with a locking compression plate is a reliable method.

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Treatment of Two- and Three-Part Fracture of Proximal Humerus using LCP

Cited by 7 publications

References 17 publications

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

Effect of Calcar Screw in Locking Compression Plate System for Osteoporotic Proximal Humerus Fracture: A Finite Element Analysis Study

Internal Fixation of Proximal Humerus Fracture with Locking Compression Plate

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