The relevance of neutral arm positioning for true ap-view X-ray to provide true projection of the humeral head shaft angle

2015 ◽  
Vol 136 (2) ◽  
pp. 213-221 ◽  
Author(s):  
Clemens Hengg ◽  
Peter Mayrhofer ◽  
Simon Euler ◽  
Markus Wambacher ◽  
Michael Blauth ◽  
...  
Keyword(s):  
Humeral Head ◽  
X Ray ◽  
Shaft Angle ◽  
Head Shaft Angle

scholarly journals Is loss of fixation following locked plating of proximal humeral fractures related to the number of screws and their positions in the humeral head?

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Mohammad Maddah ◽  
Wolf C. Prall ◽  
Lucas Geyer ◽  
Stefan Wirth ◽  
Wolf Mutschler ◽  
...  
Keyword(s):  
Humeral Head ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Spearman Correlation ◽  
Locked Plating ◽  
Secondary Fracture ◽  
Secondary Loss ◽  
Cutting Out ◽  
Shaft Angle ◽  
Head Shaft Angle

The aim of the study was to examine the correlation between the chosen position of screws and the complications observed in patients who underwent locked plating of proximal humeral fractures. We evaluated radiographs of 367 patients treated by locked-plating for proximal humeral fractures. Radiographs were taken at one day, 6 weeks, 3 months and 6 months after surgery, and were analyzed for secondary fracture displacement, loss of fixation, cutting out of screws and necrosis of the humeral head. Secondary loss of fixation occurred in 58 cases (15.8%) and among those cutting out of screws was observed in 25 cases (6.8%). In cases of secondary loss of fixation a mean of 6.7 screws were used to fix the fracture (<em>vs</em> 6.6, P=0.425). There was neither significant correlation between position of screws and the occurrence of postoperative loss of fixation in Spearman correlation nor relationship from backward logistic regression analysis. Loss of fixation following locked plating of proximal humeral fractures does not relate to the number of screws and their positions in the humeral head. In consequence, anatomic fracture reduction and restoration of the humeral head-shaft angle are still important factors and should not be disregarded.

Regarding “The rotation of the humeral head does not alter radiographic evaluation of the head-shaft angle”

2016 ◽  
Vol 25 (11) ◽  
pp. e365-e366
Author(s):  
Clemens Hengg ◽  
Simon Euler ◽  
Markus Wambacher ◽  
Michael Blauth ◽  
Franz Kralinger
Keyword(s):  
Humeral Head ◽  
Radiographic Evaluation ◽  
Shaft Angle ◽  
Head Shaft Angle

The rotation of the humeral head does not alter radiographic evaluation of the head-shaft angle

2016 ◽  
Vol 25 (4) ◽  
pp. 543-547 ◽  
Author(s):  
Eduardo A. Malavolta ◽  
Jorge H. Assunção ◽  
Raphaella A. Pagotto ◽  
Rafael L. Avelino ◽  
Mauro E.C. Gracitelli ◽  
...  
Keyword(s):  
Humeral Head ◽  
Radiographic Evaluation ◽  
Shaft Angle ◽  
Head Shaft Angle

Decision making in the management of malunion and nonunion of intertrochanteric fractures of the hip

2019 ◽  
Vol 30 (6) ◽  
pp. 793-798 ◽  
Author(s):  
Kaushik Bhowmick ◽  
Thomas Matthai ◽  
Perumal Ramaswamy JVC Boopalan ◽  
Thilak S Jepegnanam
Keyword(s):  
Decision Making ◽  
Functional Outcomes ◽  
Intertrochanteric Fracture ◽  
Distal Femur ◽  
Femur Fracture ◽  
Intertrochanteric Fractures ◽  
Non Union ◽  
Shaft Angle ◽  
Head Shaft Angle

Aim: Intertrochanteric fractures account for almost 50% of hip fractures.Nonunion and malunion of these fractures are relatively uncommon. This study reviews the outcome of 31 cases of intertrochanteric fracture failures. An algorithm for the management of these injuries is also proposed. Methods: 19 patients with intertrochanteric malunion and 12 patients with non-union were included in this study. Treatment of these injuries was initiated according to the algorithm proposed in this study. Treatment outcomes were evaluated by assessing union, pre and postoperative shortening and HSA (head-shaft angle). Functional outcomes were assessed by the Parker mobility scale and presence or absence of pain. Results: All the patients with intertrochanteric malunion with follow-up had united. The postoperative shortening in all patients were ⩽2.5 cms. Patients having intertrochanteric nonunion with follow-up, who underwent internal fixation had united with an acceptable Parker mobility scale score, except in 1 patient who sustained an ipsilateral distal femur fracture. The average HSA correction obtained was 21° (range 3–60°). Conclusion: The algorithm proposed in this study helps streamline the treatment according to each case scenario.It helps in planning and managing patients with intertrochanteric fracture failures.

scholarly journals Study of operative management of proximal humerus fracture treated with locking plates

2016 ◽  
Vol 2 (4) ◽  
pp. 318
Author(s):  
Bhavik Y. Dalal ◽  
Dipalkumar V. Rathod ◽  
Raghav Suthar ◽  
Harshal Damor
Keyword(s):  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Operative Management ◽  
Humerus Fracture ◽  
Shaft Angle ◽  
Philos Plate ◽  
Type 3 ◽  
Radiological Union ◽  
Head Shaft Angle ◽  
Shoulder Score

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">This study was undertaken to evaluate the efficacy of Philos plate and to specifically study the clinical outcome of the patient treated with Philos plate for proximal humerus fracture on the radiological head shaft angle basis.</span></p><p class="abstract"><strong>Methods:</strong> 40 cases of proximal humerus fracture fixed by using Philos plate were reviewed.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Average constant shoulder score as Neer type-3 fracture is 83.8% and for type- 4 part fracture is 86%. Average radiological union was seen at 10.2 weeks. There was no major difference in clinical and radiological union. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Good functional outcome with Philos plate irrespective of fracture type was obtained.</span></p>

scholarly journals Is head–shaft angle a valuable continuous risk factor for hip migration in cerebral palsy?

2016 ◽  
Vol 10 (6) ◽  
pp. 651-656 ◽  
Author(s):  
Sanjay Chougule ◽  
John Dabis ◽  
Aviva Petrie ◽  
Karen Daly ◽  
Yael Gelfer
Keyword(s):  
Risk Factor ◽  
Cerebral Palsy ◽  
Shaft Angle ◽  
Hip Migration ◽  
Head Shaft Angle

Nonunion Paediatric Femoral Neck Fracture Treatment without Open Reduction

2016 ◽  
Vol 26 (6) ◽  
pp. 608-611 ◽  
Author(s):  
Perajit Eamsobhana ◽  
Kamolporn Keawpornsawan
Keyword(s):  
Femoral Neck ◽  
Open Reduction ◽  
Harris Hip Score ◽  
Coxa Vara ◽  
Fracture Treatment ◽  
X Ray ◽  
Neck Shaft Angle ◽  
Nonunion Site ◽  
Neck Fracture ◽  
Shaft Angle

Objectives Fractures of the proximal femur account for less than 1% of all children's fractures. Because of this, most orthopaedic surgeons lack enough experience in treating them. This adds to the rather high incidence of complications especially nonunion. At the time of this review there is no consensus on which method of treatment of the nonunion is the best. The objective of this study is to present our method of treatment to correct the nonunion without open reduction of the nonunion sites. Method 9 children with nonunion of the proximal femur with an average age of 10.2 years (2-14 years old) were included in the study. There were 7 males and 2 females. All of them underwent at least 1 operation to treat the initial fractures and the nonunion. The nonunion in all these 9 cases was treated with valgus intertrochanteric osteotomy without open reduction of the nonunion site. The healing time of the nonunion, the postoperative neck-shaft angle and the functional outcome were evaluated. Results All the nonunion cases had coxa vara and had bone resorption of the femoral neck with x-ray evidences of avascular necrosis (AVN). Ratliff classification was used to classify the AVN, Ratliff type 3 was found in 4 cases, Ratliff 2 in 1 case and Ratliff 1 in 4 cases. Patients were followed for an average of 68 (range 36-156) months. All patients had x-ray evidence of solid union of the nonunion in an average time of 15.4 (range 13-18) weeks and union of the osteotomy sites within10.6 (range 9-12) weeks. The postoperative neck-shaft angle averaged 135° (range 125°-150°) compared to 98° before the surgery. The increase in the amount of neck-shaft angle was statistically significant (p<0.001). Using Harris Hip Score, 2 patients were graded as excellent, 3 patients were graded as good and 4 patients were graded as fair. Harris Hip Score was significantly improved compared to the preoperative status (p<0.001). Conclusions Nonunion paediatric femoral neck fracture treatment could be successfully treated without open reduction by using valgus intertrochanteric osteotomy. All patients obtained union of the nonunion site and the osteotomy site in this study. Harris Hip Score showed significant improvement. This technique can be used to treat nonunion with associated coxa vara, bone resorption and AVN with satisfactory results even in cases who had received several operations before.

Sign in / Sign up

Export Citation Format

Share Document