scholarly journals Outcomes of Mini-Invasive Arthroscopic Arthrolysis Combined with Locking Screw and/or Intramedullary Nail Extraction after Osteosynthesis of the Proximal Humerus Fracture

2022 ◽  
Vol 11 (2) ◽  
pp. 362
Author(s):  
Roman Madeja ◽  
Jana Pometlová ◽  
Roman Brzóska ◽  
Jiří Voves ◽  
Lubor Bialy ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Arthroscopic Arthrolysis ◽  
Forward Flexion ◽  
Median Increase ◽  
Procedural Complications ◽  
Locking Screw ◽  
Osteosynthetic Material ◽  
Shoulder Score

Data on the effectiveness of arthroscopic arthrolysis and extraction of osteosynthetic material after osteosynthesis of the proximal humerus in patients with persisting problems are rare and insufficient. In this study, we performed arthroscopic arthrolysis and extraction of fixation screws, and, where protruding, extraction of the nail in 34 patients with problems persisting 12 months after osteosynthesis of the proximal humerus using an intramedullary nail. The effectiveness of the treatment was assessed using the Constant–Murley shoulder score and forward flexion difference between the treated arm and the contralateral one. A median increase of 16 points in CMS score and 30 degrees reduction in the arm forward flexion difference was recorded 12 months after the arthroscopy. The improvement was significantly higher in the patient group with intramedullary nail extraction (however, this group had worse pre-operative values and the screw was only extracted where likely to cause problems). The median time to heal was 11 weeks; no serious peri- or post-procedural complications occurred. Mini-invasive arthroscopic arthrolysis combined with extraction of osteosynthetic material proved to be a safe and effective method for treatment of patients after osteosynthesis of the proximal humerus using an intramedullary nail with persisting pain and/or mobility limitation.

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 Evaluation of intramedullary nail fixation via the Neviaser portal for proximal humerus fracture

2019 ◽  
Vol 10 (3) ◽  
pp. 474-479 ◽  
Author(s):  
Yoshitaka Tanaka ◽  
Hiroyuki Gotani ◽  
Kosuke Sasaki ◽  
Tomonobu Yoshimura ◽  
Hirohisa Yagi
Keyword(s):  
Intramedullary Nail ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture

Fixation of a Proximal Humerus Fracture With an Intramedullary Nail

2017 ◽  
Vol 31 ◽  
pp. S47-S49 ◽  
Author(s):  
Andrew D. Sobel ◽  
Kalpit N. Shah ◽  
E. Scott Paxton
Keyword(s):  
Intramedullary Nail ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture

scholarly journals MRI evaluation of axillary neurovascular bundle: Implications for minimally invasive proximal humerus fracture fixation

2021 ◽  
Vol 5 (2) ◽  
pp. 205-211
Author(s):  
Eric B. Wilkinson ◽  
Johnathan F. Williams ◽  
Kyle D. Paul ◽  
Jun Kit He ◽  
Justin R. Hutto ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Fracture Fixation ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Neurovascular Bundle ◽  
Humerus Fracture ◽  
Mri Evaluation

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

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.

Axillary Artery Dissection and Thrombosis after Closed Proximal Humerus Fracture – a Rare Interdisciplinary Challenge

2019 ◽  
Vol 158 (04) ◽  
pp. 406-413
Author(s):  
Sam Razaeian ◽  
Saad Rustum ◽  
Lena Sonnow ◽  
Rupert Meller ◽  
Christian Krettek ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Brachial Plexus ◽  
Functional Recovery ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Axillary Artery ◽  
Low Energy ◽  
Artery Dissection ◽  
Brachial Plexopathy ◽  
Rare Injury

Abstract Background Proximal humerus fractures account for 4 – 6% of all fractures and are a common result of low-energy trauma in the elderly. Concomitant neurovascular injury of the neighboring axillary artery and brachial plexus is a rarity, but has enormous impact on therapy, rehabilitation and prognosis. Diagnosis of axillary artery injury may be delayed due to its varied clinical presentation and lead to prolonged ischemia, distal necrosis and even loss of limb. Thorough clinical examination, high suspicion and identification of known predictors can be helpful in early diagnosis of this rare injury. Patients/Material and Methods We report a case of an intoxicated 76-year-old male who sustained a dislocated proximal humerus fracture, resulting in concomitant brachial plexopathy and axillary artery dissection with secondary thrombosis after a low-energy fall from standing height. Due to mistriage as a neurological emergency the somnolent patient presented under delayed circumstances at our traumatological emergency department, demonstrating pain, paleness, paralysis, paresthesia and non-palpable wrist pulses. Diagnosis was made through high suspicion after clinical examination with the aid of CT angiography. Emergent open reduction and anatomic shoulder hemiarthroplasty was performed followed by axillobrachial interposition grafting using a reversed saphenous vein graft and brachial plexus exploration. Results The surgical treatments were uncomplicated. The affected limb remains viable at 6-week follow-up; however, active shoulder function is limited due to residual brachial plexopathy. Conclusion Despite early diagnosis and management of this rare injury, the prognosis for functional recovery is guarded and largely dictated by the extent of neurological injury in the setting of concomitant brachial plexopathy. Brachial plexopathy is highly associated with axillary artery injury and its impact often underestimated in comparison due to its non-limb-threatening nature in the acute setting. Future studies should focus on the long-term prognosis for functional recovery in patients with this rare injury pattern.

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