The Repair of an Acute Pathological Subtrochanteric Femur Fracture Using an Adult 3.5-mm Proximal Humerus Locking Plate in an Adolescent Patient

In these case series, we used titanium locking compression plate-distal femur (LCP-DF) plate (Synthes) 9–11 hole using less invasive stabilization system or open reduction technique. This case series aims to determine the functional scores on reverse distal femoral locking plate for subtrochanteric femur fracture. A 34-year-old male with closed subtrochanteric fracture of the right femur (Seinsheimer 2B) with Harris hip scores (HHS) of 17, 96, and 97 obtained consecutively in 0, 6, and 12 months, respectively. A 24-year-old male with closed comminuted subtrochanteric fracture of the right femur (Seinsheimer V) with HHS of 13, 93, and 97 at 0, 6, and 12 months respectively. A 39-year-old male with non-union, left subtrochanteric femur fracture (Seinsheimer 2C) yielded HHS of 38, 73, and 77 at 0, 6, and 12 months, respectively. A 35-year-old female with close subtrochanteric fracture of the right femur (Seinsheimer IIB) yielded HHS of 23, 40, and 73 at 0, 6, and 12 months, respectively. Mean initial HHS and scores at 6 and 12 months reached 22, 75, and 86, respectively.

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Effects of medial column positive and negative support on proximal humerus fracture with locking plate

10.1055/s-0040-1717546 ◽

2020 ◽

Author(s):

L Heng ◽

K Zhang

Keyword(s):

Proximal Humerus Fracture ◽

Locking Plate ◽

Proximal Humerus ◽

Humerus Fracture ◽

Negative Support

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Biomechanical design prognosis of two extramedullary fixation devices for subtrochanteric femur fracture: a finite element study

Medical & Biological Engineering & Computing ◽

10.1007/s11517-020-02306-6 ◽

2021 ◽

Author(s):

Pratik Nag ◽

Souptick Chanda

Keyword(s):

Finite Element ◽

Femur Fracture ◽

Finite Element Study ◽

Fixation Devices ◽

Extramedullary Fixation ◽

Subtrochanteric Femur Fracture ◽

Element Study

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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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02094-7 ◽

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.

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How Many Proximal Screws Are Needed for a Stable Proximal Humerus Fracture Fixation?

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459321992744 ◽

2021 ◽

Vol 12 ◽

pp. 215145932199274

Author(s):

Hyojune Kim ◽

Myung Jin Shin ◽

Erica Kholinne ◽

Janghyeon Seo ◽

Duckwoo Ahn ◽

...

Keyword(s):

Cyclic Loading ◽

Proximal Humerus Fracture ◽

Locking Plate ◽

Proximal Humerus ◽

Humerus Fracture ◽

Proximal Fragment ◽

Maximum Displacement ◽

Significant Difference ◽

Load To Failure ◽

Screw Group

Purpose: This biomechanical study investigates the optimal number of proximal screws for stable fixation of a 2-part proximal humerus fracture model with a locking plate. Methods: Twenty-four proximal humerus fracture models were included in the study. An unstable 2-part fracture was created and fixed by a locking plate. Cyclic loading and load-to-failure tests were used for the following 4 groups based on the number of screws used: 4-screw, 6-screw, 7-screw, and 9-screw groups. Interfragmentary gaps were measured following cyclic loading and compared. Consequently, the load to failure, maximum displacement, stiffness, and mode of failure at failure point were compared. Results: The interfragmentary gaps for the 4-screw, 6-screw, 7-screw, and 9-screw groups were significantly reduced by 0.24 ± 0.09 mm, 0.08 ± 0.06 mm, 0.05 ± 0.01 mm, and 0.03 ± 0.01 mm following 1000 cyclic loading, respectively. The loads to failure were significantly different between the groups with the 7-screw group showing the highest load to failure. The stiffness of the 7-screw group was superior compared with the 6-screw, 9-screw, and 4-screw groups. The maximum displacement before failure showed a significant difference between the comparative groups with the 4-screw group having the lowest value. The 7-screw group had the least structural failure rate (33.3%). Conclusion: At least 7 screws would be optimal for proximal fragment fixation of proximal humerus fractures with medial comminution to minimize secondary varus collapse or fixation failure. Level of Evidence: Basic science study.

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