Surgical Treatment of Proximal Humeral Fractures with Short Straight Intramedullary Nail

Long term surgical treatment results were studied for 30 patients (10 male and 20 female) with two- and three-fragment proximal humeral fractures with short intramedullary nail. Mean age of patients was 68.8 (37-84) years. All patients were examined clinically and roentgenologically. In postoperative period secondary varus deformity was observed in18 (60%) patients and made up 4.3° at an average. Roentgenologic signs of delayed fracture consolidation due to the loss of reposition and decrease of neck-shaft angle under 120° were observed in one case. Evaluation by ASES scale made up 90.73±7.01 points, by SST scale - 10.47±1.41 points. Treatment results for three-fragment fractures were not as good as for two-fragment ones however the difference was not statistically significant ( p >0.05). Obtained data showed the high efficacy of short straight intramedullary nail application in two- and three-fragment proximal humeral fractures.

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Surgical Treatment of Proximal Humeral Fractures with Short Straight Intramedullary Nail

N N Priorov Journal of Traumatology and Orthopedics ◽

10.32414/0869-8678-2015-4-17-20 ◽

2015 ◽

pp. 17-20 ◽

Cited By ~ 2

Author(s):

P. V. Bondarenko ◽

N. V. Zagorodniy ◽

S. I. Gil’Fanov ◽

A. Yu. Semenistyi ◽

A. A. Semenistyi ◽

...

Keyword(s):

Surgical Treatment ◽

Intramedullary Nail ◽

Varus Deformity ◽

Proximal Humeral Fractures ◽

Humeral Fractures ◽

Treatment Results ◽

Neck Shaft Angle ◽

Case Evaluation ◽

Fracture Consolidation ◽

The Difference

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

10.21203/rs.2.14214/v2 ◽

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.

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Significance and Clinical Effect of Anteromedial Support Plate Assisted Reduction and Fixation in The Treatment of Complex Proximal Humeral Fractures

10.21203/rs.3.rs-989301/v1 ◽

2021 ◽

Author(s):

XiaoTian Ma ◽

WeiYa Zhang ◽

Zheng Xu

Keyword(s):

Shoulder Joint ◽

Proximal Humeral Fractures ◽

Humeral Fractures ◽

Control Group ◽

Study Group ◽

Dash Score ◽

Neck Shaft Angle ◽

Support Plate ◽

Shaft Angle ◽

The Difference

Abstract Background There are more and more complex consolidated proximal fractures, and the postoperative effect is not very satisfactory. Therefore, we propose a surgical method and evaluate its effect. Method A total of 77 patients with complicated proximal humeral fractures who underwent surgical treatment in the Affiliated Hospital of Nantong University from June 2015 to January 2019 were collected. Among them, the internodal groove medial support plate assisted reduction and fixation technique and the lateral locking plate were used. A total of 15 cases of complicated proximal humeral fractures were used as the study group, and 62 patients with the same type of proximal humeral fractures treated with traditional reduction methods and internal fixation with lateral locking plates during the same period were used as the control group.The operation time of the two groups; intraoperative blood loss; number of effective intraoperative fluoroscopy; postoperative humeral neck shaft angle loss after reduction; postoperative shoulder joint Constant-Murley score; upper limb function DASH score and postoperative complications were retrospectively reviewed comparative analysis. Results The number of effective intraoperative fluoroscopy was (6.18±1.869) times in the control group, more than (3.93±1.387) times in the study group, and the difference between the two was statistically significant (P<0.05);The operation time of the study group was longer than that of the control group, and the intraoperative blood loss of the study group was more than that of the control group, but the difference between the two was not statistically significant (P>0.05).In the first 1, 3, 6, and 12 months after surgery, in terms of imaging measurement, the loss angle after reduction of the humeral neck shaft angle in the control group and the study group increased with the increase in postoperative time. There was no significant difference in the lost angle after reduction of the humeral neck shaft angle between the two groups at month and 3 months (P>0.05).At the 6th and 12th months after surgery, the lost angle after reduction of the humeral neck shaft angle in the study group was smaller than that in the control group, and the difference between the two groups was statistically significant (P<0.05).For the recovery of shoulder joint function after surgery, the Constant-Murley score of the shoulder joint and the DASH score of upper limb function of the control group and the study group increased with the increase of postoperative time, while the Constant score and DASH score of the two groups were 1 after surgery. There was no significant difference at months, 3 months, 6 months and 12 months (P>0.05). Conclusion The anteromedial support plate assisted reduction of the internodal groove can be used as a single locking plate for the treatment of complex proximal humeral fractures with medial column instability. It is an option when reduction is difficult or it is difficult to maintain stable reduction, which improves the quality of reduction and reduces surgery. Loss of posterior fracture reduction.

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

10.21203/rs.2.14214/v1 ◽

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.

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Surgical Treatment With an Angular Stable Plate for Complex Displaced Proximal Humeral Fractures in Elderly Patients: A Randomized Controlled Trial

Yearbook of Orthopedics ◽

10.1016/j.yort.2012.04.021 ◽

2012 ◽

Vol 2012 ◽

pp. 136-138

Author(s):

M.F. Swiontkowski

Keyword(s):

Randomized Controlled Trial ◽

Surgical Treatment ◽

Elderly Patients ◽

Controlled Trial ◽

Proximal Humeral Fractures ◽

Humeral Fractures ◽

Randomized Controlled

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A Single Retrograde Intramedullary Nail Technique for Treatment of Displaced Proximal Humeral Fractures in Children

JBJS Open Access ◽

10.2106/jbjs.oa.20.00119 ◽

2021 ◽

Vol 6 (1) ◽

pp. e20.00119

Author(s):

Eleftheria Samara ◽

Benjamin Tschopp ◽

Barbara Kwiatkowski ◽

Elif Vardar ◽

Nicolas Lutz ◽

...

Keyword(s):

Intramedullary Nail ◽

Proximal Humeral Fractures ◽

Humeral Fractures ◽

Retrograde Intramedullary Nail ◽

Fractures In Children

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Surgical treatment of complex proximal humeral fractures in elderly patients: a matched-pair analysis of angular-stable plating vs. reverse shoulder arthroplasty

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2020.01.073 ◽

2020 ◽

Vol 29 (9) ◽

pp. 1796-1803

Author(s):

Alexander Klug ◽

Jasmin Harth ◽

Reinhard Hoffmann ◽

Yves Gramlich

Keyword(s):

Surgical Treatment ◽

Elderly Patients ◽

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Proximal Humeral Fractures ◽

Humeral Fractures ◽

Matched Pair ◽

Matched Pair Analysis ◽

Complex Proximal Humeral Fractures ◽

Pair Analysis

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

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2907-3 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 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.

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