scholarly journals Locking plate for displaced proximal humerus fractures-outcomes and complications: a prospective study

2019 ◽  
Vol 5 (6) ◽  
pp. 1178
Author(s):  
Avinash Rathod ◽  
Gopisankar Balaji ◽  
Dilip Patro
Keyword(s):  
Locking Plate ◽  
Proximal Humerus ◽  
Rehabilitation Program ◽  
Proximal Humerus Fractures ◽  
Fixation Techniques ◽  
Study Population ◽  
Screw Penetration ◽  
Humerus Fractures ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The management of unstable proximal humerus fractures is controversial as many fixation techniques have evolved over the years claiming to be a better fixation device compared to the other.</p><p class="abstract"><strong>Methods:</strong> 23 patients with closed displaced proximal humerus fractures were included in this study. All patients underwent open reduction and internal fixation with proximal humerus locking plate through either delto-pectoral or deltoid splitting approach. Standard shoulder rehabilitation program was used in all cases. Functional and radiological outcome were assessed at follow-up.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean constant-Murley score achieved at 6 months was 66. Complications were reported in a total of 7 patients including 3 varus malunion, 1 valgus malunion, 2 screw penetration into the joint and 1 nonunion with implant breakage.</p><p class="abstract"><strong>Conclusions:</strong> The proximal humeral locking plate seems to be an adequate device for the fixation of displaced proximal humerus fractures as 83% of our study population had good/moderate functional outcomes.</p><p class="abstract"> </p>

scholarly journals Evaluation of Functional Outcome of Management of Proximal Humerus Fractures by Different Treatment Modalities

2020 ◽  
Author(s):  
Sudhir Shyam Kushwaha ◽  
Ambrish Thakur ◽  
Yasir Ali Khan ◽  
Amit Verma ◽  
Farid Mohammed ◽  
...  
Keyword(s):  
Locking Plate ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Early Mobilisation ◽  
Group A ◽  
Humerus Fractures ◽  
Group B ◽  
Group D ◽  
Shoulder Score

Introduction: Proximal humerus fractures account for 4-5% of all fractures and could be managed both conservatively and surgically. As much as 85% minimally or non-displaced fractures can be managed conservatively. In spite of early union and exercise programme by conservative treatment, the problem of shoulder stiffness is common. To overcome stiffness, early mobilisation is mandatory which is not possible in conservative treatment before three weeks. Therefore, surgical intervention is needed for early mobilisation and early return of function. Aim: To compare the functional outcome between the four common methods of managing proximal humerus fractures namely locking plate, Joshi External Stabilisation System (JESS), percutaneous K-wire fixation and conservative method. Materials and Methods: Patients with proximal humerus fracture above 18 years of age between August 2011 to August 2013 were included in the study. The study population was divided into four groups viz., Group A, B, C, D depending on the mode of treatment by locking plate, external fixator, K-wire fixation and conservative method of treatment, respectively. The patients were followed-up at 3 weeks, 6 weeks, 12 weeks, 18 weeks and thereafter every 6 weeks’ interval till 9 months. After union, cases were evaluated radiologically and clinically for functional results by using the Swanson Shoulder Score and Constant Scoring System (Modified). Results: At the end of the study there were 17 patients in the Group ‘A’, 7 patients in the Group ‘B’, 7 patients in the Group ‘C’ and 11 patients in Group ‘D’. At 9 months of follow-up according to modified constant shoulder score the percentage of excellent score in group A was maximum. Group B and Group D had maximum number of good scores. The mean constant shoulder score increased in all groups at 9 months of follow-up as compared to 3 months of follow-up except in group D. Similarly, according to Swanson’s shoulder score, group A had the maximum number of excellent scores. Conclusion: From the above study it can be concluded locking plates are an excellent modality of treatment of proximal humerus fractures with excellent union rate and early mobilisation.

scholarly journals A novel surgical approach and technique and short-term clinical efficacy for the treatment of proximal humerus fractures with the combined use of medial anatomical locking plate fixation and minimally invasive lateral locking plate fixation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fu Wang ◽  
Yan Wang ◽  
Jinye Dong ◽  
Yu He ◽  
Lianxin Li ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Shoulder Joint ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Anterolateral Approach ◽  
Proximal Humerus Fractures ◽  
Locking Plate Fixation ◽  
Humerus Fractures

Abstract Background and hypothesis The typical anterolateral approach is widely used to treat proximal humerus fractures with lateral locking fixation. However, lateral fixation cannot completely avoid medial reduction loss and varus deformity especially in the cases of an unstable medial column. We present a novel medial surgical approach and technique together with a minimally invasive lateral locking plate to fix proximal humerus fractures with an unstable medial column. Materials and methods We performed an anatomical study and reported 8 cases of proximal humerus fractures with unstable medial columns treated with plate fixation through a minimally invasive anterolateral approach and medial approach. All surgeries were performed by the same single surgeon. Patients were followed clinically and radiographically at 1, 3, 6, and 12 months postoperatively. Results There was a safe region located at the medial part of the proximal humerus just beneath the articular surface. An anatomical medial locking proximal humerus plate could be placed in the medial column and did not affect the axillary nerve, blood supply of the humeral head, or stability of the shoulder joint. Successful fracture healing was achieved in all 8 cases. The function and range of motion of the shoulder joint were satisfactory 24 months postoperatively, with an average Constant score (CS) of 82.8. No reduction loss (≥ 10° in any direction), screw cutout, nonunion, or deep infection occurred. Conclusions The combined application of medial anatomical locking plate fixation and minimally invasive lateral locking plate fixation is effective in maintaining operative reduction and preventing varus collapse and implant failure in proximal humerus fractures with an unstable medial column.

A systematic review of locking plate fixation of proximal humerus fractures

Injury ◽  
2011 ◽  
Vol 42 (4) ◽  
pp. 408-413 ◽  
Author(s):  
Robert C. Sproul ◽  
Jaicharan J. Iyengar ◽  
Zlatko Devcic ◽  
Brian T. Feeley
Keyword(s):  
Systematic Review ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Proximal Humerus Fractures ◽  
Locking Plate Fixation ◽  
Humerus Fractures

Outcomes of Arthroscopic Hardware Removal Following Locked Plating of Proximal Humerus Fractures: A Prospective Study

2015 ◽  
Vol 24 (8) ◽  
pp. e230
Author(s):  
Joshua S. Dines ◽  
Matthew R. Garner ◽  
Asheesh Bedi ◽  
Kristofer Jones ◽  
Dean G. Lorich ◽  
...  
Keyword(s):  
Prospective Study ◽  
Proximal Humerus ◽  
Hardware Removal ◽  
Proximal Humerus Fractures ◽  
Locked Plating ◽  
Humerus Fractures ◽  
A Prospective Study

Is serial radiological evaluation of one-part proximal humeral fractures necessary?

2019 ◽  
Vol 101-B (10) ◽  
pp. 1307-1312
Author(s):  
Matthijs Jacxsens ◽  
Jeremias Schmid ◽  
Vilijam Zdravkovic ◽  
Bernhard Jost ◽  
Christian Spross
Keyword(s):  
Bone Quality ◽  
Proximal Humerus ◽  
Constant Score ◽  
Nonoperative Treatment ◽  
Proximal Humerus Fractures ◽  
Radiological Evaluation ◽  
Fracture Configuration ◽  
Secondary Displacement ◽  
Humerus Fractures

Aims In order to determine whether and for whom serial radiological evaluation is necessary in one-part proximal humerus fractures, we set out to describe the clinical history and predictors of secondary displacement in patients sustaining these injuries. Patients and Methods Between January 2014 and April 2016, all patients with an isolated, nonoperatively treated one-part proximal humerus fracture were prospectively followed up. Clinical and radiological evaluation took place at less than two, six, 12, and 52 weeks. Fracture configuration, bone quality, and comminution were determined on the initial radiographs. Fracture healing, secondary displacement, and treatment changes were recorded during follow-up. Results In 100 patients (59 female, 41 male; mean age 57 years), 91 of the fractures (91%) remained stable. In five of nine patients (55%) with secondary displacement, surgery was recommended. Comminution, present in 23 patients (23%), was identified as a predictor of secondary displacement (p < 0.001). Patients’ age, sex, fracture configuration, and bone quality were not associated with secondary displacement (p ≥ 0.438). Nonoperative treatment resulted in a mean absolute Constant score (CS) of 80 (49 to 98), relative CS of 101% (63% to 138%), median subjective shoulder value of 95% (interquartile range (IQR) 90% to 100%), and median EuroQol five-dimensional questionnaire score of 0.89 (IQR 0.80 to 1.00) with bone union in all cases at one-year follow-up. Conclusion Radiological re-evaluation was only necessary in patients presenting with comminution and may be redundant for 77% of patients with one-part proximal humerus fractures. Nonoperative treatment of one-part proximal humerus fractures remains the mainstay of treatment with a low rate of secondary surgery, a high union rate, and good clinical results. Cite this article: Bone Joint J 2019;101-B:1307–1312

Evaluating Periarticular Screw Margins for Locking Plate Osteosynthesis of Proximal Humerus Fractures

2018 ◽  
Vol 04 (01) ◽  
Author(s):  
Sheriff D Akinleye ◽  
Ramin Sadeghpour ◽  
Maya D Culbertson ◽  
Garret Garofolo Gonzalez ◽  
Jack Choueka
Keyword(s):  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Osteosynthesis ◽  
Proximal Humerus Fractures ◽  
Locking Plate Osteosynthesis ◽  
Humerus Fractures
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