High bone union rate using a locking plate for proximal humeral fractures in patients older than 70 years: importance of the medial column

2021 ◽  
Author(s):  
Won Chul Shin ◽  
Suk-Woong Kang ◽  
Seung Min Son ◽  
Jae Seung Seo ◽  
Min Hyeok Choi
Keyword(s):  
Locking Plate ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Bone Union ◽  
Union Rate ◽  
High Bone

scholarly journals Assessment of the Efficacy of the Far Cortical Locking Technique in Proximal Humeral Fractures: A Comparison with the Conventional Bi-cortical Locking Technique 

2020 ◽  
Author(s):  
joongbae seo ◽  
Yoenjun Kim ◽  
Kyubeom Kim ◽  
Jae-Sung Yoo
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Callus Formation ◽  
Constant Score ◽  
Plate Fixation ◽  
Treatment Strategies ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Union Rate ◽  
Locking Plate Fixation

Abstract Background Locking plate fixation is one of the treatment strategies for the management of proximal humeral fractures. However, stiffness after locking plate fixation is a clinical concern. The mechanical stiffness of the standard locking plate system may suppress the interfragmentary motion necessary to promote secondary bone healing by callus formation. The far cortical locking (FCL) technique was developed to address this limitation in 2005. FCL increases construct flexibility and promotes callus formation. Our study aimed to evaluate the clinical and radiological outcomes of the FCL technique when implemented in proximal humeral fracture management. Furthermore, we compared the surgical outcomes of FCL with those of the conventional bicortical locking (BCL) screw fixation technique.Methods Forty-five consecutive patients who had undergone locking fixation for proximal humeral fractures were included in this study. A proximal humeral locking plate (PHILOS) system with BCL screw fixation was used in the first 27 cases, and the periarticular proximal humeral locking plate with FCL screw fixation was used in the final 18 consecutive cases. Functional capacity was assessed using the constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion. Radiographic outcomes were evaluated using the Paavolainen method of measuring the neck-shaft angle (NSA).Results No significant differences in clinical outcomes (ASES score, constant score, and range of motion)were found between the two groups. The union rate at 12 weeks was significantly higher in the FCL group (94.4%) than in the BCL group (66.7%, p=0.006). No significant differences in NSA were found between the two treatment strategies. The complication rate was not significantly different between the two groups.Conclusions When implemented in proximal humeral fractures, the FCL technique showed satisfactory clinical and radiological outcomes as compared with the conventional BCL technique. The bone union rate at 12 weeks after surgery was significantly higher in the FCL group than in the BCL group. However, no significant difference in the final bone union rate was found between the two groups.

scholarly journals Results of surgery using a locking plate for proximal humerus fractures in patients older than 80 years: A retrospective case series

2019 ◽  
Author(s):  
Won Chul Shin ◽  
Suk-Woong Kang ◽  
Seung Min Son ◽  
Hyuk Bae
Keyword(s):  
Surgical Treatment ◽  
Locking Plate ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Bone Union ◽  
Neck Shaft Angle ◽  
Radiological Results ◽  
Comminuted Fracture ◽  
Shaft Angle ◽  
The Mean

Abstract Background: To evaluate the results of surgical treatment using a locking plate for proximal humeral fractures in patients aged >80 years. Methods: Between September of 2013 and March of 2016, there were 22 patients who received locking plate fixation from proximal humeral fractures over 80 years-old. Among the 22 cases, Clinical, radiological results were analyzed for 19 patients who were able to follow up more than one year. We analyzed bone union, neck-shaft angle, UCLA score, range of motion compared to opposite side and complication. Clinical, radiological results were investigated for medial comminuted fracture or not. Results: All the patients achieved bone union. The mean bone union time was 13.7 weeks, and the mean neck-shaft angle was 126.4. The mean University of California, Los Angeles, shoulder score was 22.4, and score was <28 point in 12 patients. The mean forward flexion, abduction, external rotation, and internal rotation angles were 129.2°, 112.3°, 44.2°, and L2. All motions were significantly different from the normal shoulder motion. A significant difference was found in the loss of neck-shaft angle according to the medial comminuted fracture. Conclusion: In the surgical treatment of proximal humeral fractures in patients aged >80 years, use of a locking plate attained bone union with relatively satisfactory results. However, we considered that prevention of and training for postoperative stiffness are necessary. Other surgical methods should be considered for patients with complex displaced fractures, especially those with medial comminuted fractures.

scholarly journals Assessment of the Efficacy of the Far Cortical Locking Technique in Proximal Humeral Fractures: A Comparison with the Conventional Bi-cortical Locking Technique 

2020 ◽  
Author(s):  
joongbae seo ◽  
Yoenjun Kim ◽  
Kyubeom Kim ◽  
Jae-Sung Yoo
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Callus Formation ◽  
Constant Score ◽  
Plate Fixation ◽  
Treatment Strategies ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Union Rate ◽  
Locking Plate Fixation

Abstract Background Locking plate fixation is one of the treatment strategies for the management of proximal humeral fractures. However, stiffness after locking plate fixation is a clinical concern. The mechanical stiffness of the standard locking plate system may suppress the interfragmentary motion necessary to promote secondary bone healing by callus formation. The far cortical locking (FCL) technique was developed to address this limitation in 2005. FCL increases construct flexibility and promotes callus formation. Our study aimed to evaluate the clinical and radiological outcomes of the FCL technique when implemented in proximal humeral fracture management. Furthermore, we compared the surgical outcomes of FCL with those of the conventional bicortical locking (BCL) screw fixation technique.Methods Forty-five consecutive patients who had undergone locking fixation for proximal humeral fractures were included in this study. A proximal humeral locking plate (PHILOS) system with BCL screw fixation was used in the first 27 cases, and the periarticular proximal humeral locking plate with FCL screw fixation was used in the final 18 consecutive cases. Functional capacity was assessed using the constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion. Radiographic outcomes were evaluated using the Paavolainen method of measuring the neck-shaft angle (NSA).Results No significant differences in clinical outcomes (ASES score, constant score, and range of motion)were found between the two groups. The union rate at 12 weeks was significantly higher in the FCL group (94.4%) than in the BCL group (66.7%, p=0.006). No significant differences in NSA were found between the two treatment strategies. The complication rate was not significantly different between the two groups.Conclusions When implemented in proximal humeral fractures, the FCL technique showed satisfactory clinical and radiological outcomes as compared with the conventional BCL technique. The bone union rate at 12 weeks after surgery was significantly higher in the FCL group than in the BCL group. However, no significant difference in the final bone union rate was found between the two groups.Level of evidence: Level III-2, Retrospective study

scholarly journals Assessment of the Efficacy of the Far Cortical Locking Technique for Proximal Humeral Fractures: A Comparison with the Conventional Bicortical Locking Technique

2020 ◽  
Author(s):  
Joong-bae Seo ◽  
Sunghyun Yoon ◽  
Hyung-Seok Yi ◽  
Jun-Kyom Kim ◽  
Kyu-Beom Kim ◽  
...  
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Callus Formation ◽  
Constant Score ◽  
Plate Fixation ◽  
Treatment Strategies ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Union Rate ◽  
Locking Plate Fixation

Abstract Background Locking plate fixation is one of the treatment strategies for the management of proximal humeral fractures. However, stiffness after locking plate fixation is a clinical concern. The mechanical stiffness of the standard locking plate system may suppress the interfragmentary motion necessary to promote secondary bone healing by callus formation. The far cortical locking (FCL) technique was developed to address this limitation in 2005. FCL allows axial motion and promotes uniform callus formation. Our study aimed to evaluate the clinical and radiological outcomes of the FCL technique when implemented in proximal humeral fracture management. Furthermore, we compared the surgical outcomes of FCL with those of the conventional bicortical locking (BCL) screw fixation technique. Methods Forty-five consecutive patients who had undergone locking fixation for proximal humeral fractures were included in this study. A proximal humeral locking plate (PHILOS) system with BCL screw fixation was used in the first 27 cases, and the periarticular proximal humeral locking plate with FCL screw fixation was used in the final 18 consecutive cases. Functional capacity was assessed using the constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion. Radiographic outcomes were evaluated using the Paavolainen method of measuring the neck-shaft angle (NSA). Results No significant differences in clinical outcomes (ASES score, constant score, and range of motion) were found between the two groups. The union rate at 12 weeks was significantly higher in the FCL group (94.4%) than in the BCL group (66.7%, p = 0.006). No significant differences in NSA were found between the two treatment strategies. The complication rate was not significantly different between the two groups. Conclusions When implemented in proximal humeral fractures, the FCL technique showed satisfactory clinical and radiological outcomes as compared with the conventional BCL technique. The bone union rate at 12 weeks after surgery was significantly higher in the FCL group than in the BCL group. However, no significant difference in the final bone union rate was found between the two groups.

scholarly journals Assessment of the Efficacy of the Far Cortical Locking Technique for Proximal Humeral Fractures: A Comparison with the Conventional Bicortical Locking Technique

2020 ◽  
Author(s):  
J.B. S. ◽  
J.S. Y. ◽  
Y.J. K. ◽  
K.B. K.
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Callus Formation ◽  
Constant Score ◽  
Plate Fixation ◽  
Treatment Strategies ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Union Rate ◽  
Locking Plate Fixation

Abstract Background Locking plate fixation is one of the treatment strategies for the management of proximal humeral fractures. However, stiffness after locking plate fixation is a clinical concern. The mechanical stiffness of the standard locking plate system may suppress the interfragmentary motion necessary to promote secondary bone healing by callus formation. The far cortical locking (FCL) technique was developed to address this limitation in 2005. FCL increases construct flexibility and promotes callus formation. Our study aimed to evaluate the clinical and radiological outcomes of the FCL technique when implemented in proximal humeral fracture management. Furthermore, we compared the surgical outcomes of FCL with those of the conventional bicortical locking (BCL) screw fixation technique.Methods Forty-five consecutive patients who had undergone locking fixation for proximal humeral fractures were included in this study. A proximal humeral locking plate (PHILOS) system with BCL screw fixation was used in the first 27 cases, and the periarticular proximal humeral locking plate with FCL screw fixation was used in the final 18 consecutive cases. Functional capacity was assessed using the constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion. Radiographic outcomes were evaluated using the Paavolainen method of measuring the neck-shaft angle (NSA).Results No significant differences in clinical outcomes (ASES score, constant score, and range of motion)were found between the two groups. The union rate at 12 weeks was significantly higher in the FCL group (94.4%) than in the BCL group (66.7%, p=0.006). No significant differences in NSA were found between the two treatment strategies. The complication rate was not significantly different between the two groups.Conclusions When implemented in proximal humeral fractures, the FCL technique showed satisfactory clinical and radiological outcomes as compared with the conventional BCL technique. The bone union rate at 12 weeks after surgery was significantly higher in the FCL group than in the BCL group. However, no significant difference in the final bone union rate was found between the two groups.Level of evidence: Level III-2, Retrospective study

scholarly journals Assessment of the efficacy of the far cortical locking technique in proximal humeral fractures: a comparison with the conventional bi-cortical locking technique

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Joong-Bae Seo ◽  
Jae-Sung Yoo ◽  
Yeon-Jun Kim ◽  
Kyu-Beom Kim
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Callus Formation ◽  
Constant Score ◽  
Plate Fixation ◽  
Treatment Strategies ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Union Rate ◽  
Locking Plate Fixation

Abstract Background Locking plate fixation is one of the treatment strategies for the management of proximal humeral fractures. However, stiffness after locking plate fixation is a clinical concern. The mechanical stiffness of the standard locking plate system may suppress the interfragmentary motion necessary to promote secondary bone healing by callus formation. The far cortical locking (FCL) technique was developed to address this limitation in 2005. FCL increases construct flexibility and promotes callus formation. Our study aimed to evaluate the clinical and radiological outcomes of the FCL technique when implemented in proximal humeral fracture management. Furthermore, we compared the surgical outcomes of FCL with those of the conventional bicortical locking (BCL) screw fixation technique. Methods Forty-five consecutive patients who had undergone locking fixation for proximal humeral fractures were included in this study. A proximal humeral locking plate (PHILOS) system with BCL screw fixation was used in the first 27 cases, and the periarticular proximal humeral locking plate with FCL screw fixation was used in the final 18 consecutive cases. Functional capacity was assessed using the constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion. Radiographic outcomes were evaluated using the Paavolainen method of measuring the neck-shaft angle (NSA). Results No significant differences in clinical outcomes (ASES score, constant score, and range of motion) were found between the two groups. The union rate at 12 weeks was significantly higher in the FCL group (94.4%) than in the BCL group (66.7%, p = 0.006). No significant differences in NSA were found between the two treatment strategies. The complication rate was not significantly different between the two groups. Conclusions When implemented in proximal humeral fractures, the FCL technique showed satisfactory clinical and radiological outcomes as compared with the conventional BCL technique. The bone union rate at 12 weeks after surgery was significantly higher in the FCL group than in the BCL group. However, no significant difference in the final bone union rate was found between the two groups.

scholarly journals Results of surgery using a locking plate for proximal humerus fractures in patients older than 80 years: A retrospective case series

2019 ◽  
Author(s):  
Won Chul Shin ◽  
Suk-Woong Kang ◽  
Seung Min Son ◽  
Hyuk Bae
Keyword(s):  
Surgical Treatment ◽  
Locking Plate ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Bone Union ◽  
Neck Shaft Angle ◽  
Radiological Results ◽  
Surgical Methods ◽  
Shaft Angle ◽  
The Mean

Abstract Background: To evaluate the results of surgical treatment using a locking plate for proximal humeral fractures in patients aged >80 years. Methods: Between September of 2013 and March of 2016, there were 22 patients who received locking plate fixation from proximal humeral fractures over 80 years-old. Among the 22 cases, Clinical, radiological results were analyzed for 19 patients who were able to follow up more than one year. We analyzed bone union, neck-shaft angle, UCLA score, range of motion compared to opposite side and complication. Clinical, radiological results were investigated for medial comminuted fracture or not.Results: All the patients achieved bone union. The mean bone union time was 13.7 weeks, and the mean neck-shaft angle was 126.4. The mean University of California, Los Angeles, shoulder score was 22.4, and score was <28 point in 12 patients. The mean forward flexion, abduction, external rotation, and internal rotation angles were 129.2°, 112.3°, 44.2°, and L2. All motions were significantly different from the normal shoulder motion. A significant difference was found in the loss of neck-shaft angle according to the medial comminuted fracture.Conclusion: In the surgical treatment of proximal humeral fractures in patients aged >80 years, use of a locking plate attained bone union with relatively satisfactory results. However, we considered that prevention of and training for postoperative stiffness are necessary. Other surgical methods should be considered for patients with complex displaced fractures, especially those with medial comminuted fractures.

scholarly journals Biomechanical evaluation of hybrid double plate osteosynthesis using a locking plate and an inverted third tubular plate for the treatment of proximal humeral fractures

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0206349 ◽  
Author(s):  
Jan Theopold ◽  
Stefan Schleifenbaum ◽  
Mirijam Müller ◽  
Michael Werner ◽  
Niels Hammer ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Biomechanical Evaluation

Treatment of comminuted proximal humeral fractures using locking plate with strut allograft

2017 ◽  
Vol 26 (5) ◽  
pp. 781-785 ◽  
Author(s):  
Hongeun Cha ◽  
Ki-Beom Park ◽  
Seungbae Oh ◽  
Jinyoung Jeong
Keyword(s):  
Locking Plate ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures
Sign in / Sign up

Export Citation Format

Share Document