Unhappy Triad After Plate Fixation of Proximal Humeral Fractures

2021 ◽  
Vol 30 (7) ◽  
pp. e467
Author(s):  
Gabriel Cardenas ◽  
Manuel Ignacio Olmos ◽  
Tyler Johnston ◽  
Pascal Boileau
Keyword(s):  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures

scholarly journals Plate Fixation for Irreducible Proximal Humeral Fractures in Children and Adolescents—A Single-Center Case Series of Six Patients

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 635
Author(s):  
Florian Freislederer ◽  
Susanne Bensler ◽  
Thomas Specht ◽  
Olaf Magerkurth ◽  
Karim Eid
Keyword(s):  
Closed Reduction ◽  
Biceps Tendon ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Constant Murley Score ◽  
Fractures In Children ◽  
Initial Surgery ◽  
Conjoint Tendon

Background: Recommended treatment for severely displaced proximal humeral fractures in children is the closed reduction and percutaneous fixation by K-wires or intramedullary nailing. Methods: From January 2016 to January 2017 6, 21 children/adolescents (range 8 to 16 years) with proximal humeral fractures were treated surgically for severe displacement. In these six patients, several attempts of closed reduction were unsuccessful, and an open reduction was performed. The humeral head was fixed with a 3.5 mm T-plate without affecting the growth plate. Plate removal was performed at a mean interval of 132 days after initial surgery. Two years after initial surgery, the clinical outcome was assessed by the Constant–Murley score and QuickDASH score (including sport/music and work) and the shoulder joint was evaluated with a standardized sonographic examination for the rotator cuff and the conjoint tendon. Results: In all six patients, dorsal displacement of the fracture was irreducible due to the interposition of tendinous or osseous structures. Intraoperatively, the interposed structures were the long biceps tendon in two, periosteal tissue in two, a bony fragment in one, and the long biceps tendon together with the conjoint tendon in one case. At mean follow-up of 26 months (range 22 months to 29 months), patients showed very good clinical results with an excellent mean Constant–Murley score of 97.5 (range 91 to 100) and mean QuickDASH score (including sport/music and work) of 5.5 (range 0–20.8). An X-ray follow-up 6 weeks after surgery demonstrated early consolidation and correct alignment in all patients. A sonographic evaluation at 2 years post injury showed that the biceps and the conjoined tendon were intact in all patients. Conclusions: If a proximal humeral fracture is not reducible by closed means, a tissue entrapment (most likely biceps tendon) should be considered. Treatment with an open reduction and plate fixation yields very good clinical and radiological results and preserves interposed structures as the biceps and conjoint tendon.

Locking plate fixation of proximal humeral fractures with impaction of the fracture site to restore medial column support: a biomechanical study

2013 ◽  
Vol 22 (11) ◽  
pp. 1552-1557 ◽  
Author(s):  
Colleen A. Weeks ◽  
Farhana Begum ◽  
Lauren A. Beaupre ◽  
Jason P. Carey ◽  
Samer Adeeb ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Fracture Site ◽  
Biomechanical Study ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation

scholarly journals Fibular strut allograft influences reduction and outcomes after locking plate fixation of comminuted proximal humeral fractures in elderly patients: a retrospective study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Xueliang Cui ◽  
Hui Chen ◽  
Binbin Ma ◽  
Wenbin Fan ◽  
He Li
Keyword(s):  
Elderly Patients ◽  
Clinical Outcomes ◽  
Locking Plate ◽  
External Rotation ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Head Height

Abstract Background Proximal humeral fractures (PHFs) are the third most commonly occurring fractures in elderly patients. Most of these fractures can be treated with conservative methods, but the optimal surgical treatment strategy for unstable fractures in elderly patients remains controversial. This study aimed to compare the radiological and clinical outcomes between locking compression plate (LCP) fixation and LCP fixation with fibular allograft implantation for the treatment of comminuted PHFs. Methods We retrospectively reviewed 60 patients (mean age, 72.75 years) with closed 3- or 4-part fractures, and a minimum of 2 years of follow-up. Fracture reduction was quantitatively determined by humeral head height (HHH) and neck-shaft angle (NSA). The clinical outcome was evaluated by Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score. Result The average radiological changes were higher in the LCP group than in the locking plate with fibular allograft group (HHH of 4.16 mm vs 1.18 mm [p < 0.001] and NSA of 9.94° versus 3.12° [p < 0.001]) . The final average outcome scores were lower in the LCP group than in the FA group (CMS of 73.00 vs 78.96 [p = 0.024] and ASES score of 72.80 vs 78.64 [p = 0.022]). The FA group showed better forward elevation (p = 0.010) and abduction (p = 0.002); however, no significant differences were observed for shoulder external rotation or internal rotation. The number of complications was higher in the LCP group (28.57%) than in the FA group (1.2%) (p < 0.001). Conclusion For comminuted PHFs in elderly patients, LCP fixation combined with a fibular allograft is reasonable option to ensure satisfactory radiological and clinical outcomes. Trial registration ZDYJLY(2018)New-9. Name of registry: IEC for clinical Research of Zhongda Hospital, Affiliated to Southeast University. Date of registration: 2018-05-17.

Locking plate fixation for proximal humeral fractures: Initial results with a new implant

2007 ◽  
Vol 16 (2) ◽  
pp. 202-207 ◽  
Author(s):  
Peter S. Rose ◽  
Christopher R. Adams ◽  
Michael E. Torchia ◽  
David J. Jacofsky ◽  
George G. Haidukewych ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation ◽  
Initial Results

scholarly journals Comparison of Intramedullary Nail Versus Locking Plate Fixation for Proximal Humeral Fractures

2009 ◽  
Vol 58 (4) ◽  
pp. 604-608 ◽  
Author(s):  
Katsuhiko Ishibashi ◽  
Gentaro Hanaishi ◽  
Kenichiro Nakai ◽  
Masato Nagashima ◽  
Hiroaki Tanaka
Keyword(s):  
Intramedullary Nail ◽  
Locking Plate ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation

Screw augmentation reduces motion at the bone-implant interface: a biomechanical study of locking plate fixation of proximal humeral fractures

2015 ◽  
Vol 24 (12) ◽  
pp. 1968-1973 ◽  
Author(s):  
Benedikt Schliemann ◽  
Robert Seifert ◽  
Steffen B. Rosslenbroich ◽  
Christina Theisen ◽  
Dirk Wähnert ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Biomechanical Study ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation ◽  
Bone Implant ◽  
Screw Augmentation
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