scholarly journals Treatment of Open Proximal Humerus Fracture by Gunshot

2012 ◽  
Vol 15 (1) ◽  
pp. 37-42
Author(s):  
Sung Jae Kim ◽  
Jae Hoo Lee ◽  
Yong Min Chun
Keyword(s):  
Internal Fixation ◽  
External Fixator ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Fracture Site ◽  
Humerus Fracture ◽  
Wound Debridement ◽  
Fracture Management

PURPOSE: To consider the proper managment of proximal humerus fracture on gunshot wounds.MATERIALS AND METHODS: A 28-year-old male patient, who sustained a gunshot injury on the left arm 5 days ago, was admitted through the emergency department. Although he underwent an emergency surgery (bullet fragment removal and debridement), there remained bullet fragments around the proximal humerus fracture site. The wound seemed to be infected and a partial dehiscence occurred. No neurologic deficit was noted. Immediate exploration and debridement were performed, and an external fixator was applied to restore the anatomical alignment and manage the wounds. Intravenous antibiotics were administered. On the 9th postoperative day, wound debridement was done again, and cement beads mixed with antibiotics were inserted. After two weeks, the external fixator was removed, and the pin sites were closed after debridement. One week later, the open reduction and internal fixation with locking compression plate and screws were done.RESULTS: At 3 months after the internal fixation, the bone union was obtained with satisfactory alignment of the humerus.CONCLUSION: The severity of the soft tissue injury influences the fracture management plan. Further, the risk on lead toxicity should be considered.

scholarly journals Outcomes of Proximal Humerus Fracture Open Reduction Internal Fixation with Concomitant Ipsilateral Shoulder Girdle Injuries: a Case Control Study

2016 ◽  
Vol 12 (2) ◽  
pp. 105-110
Author(s):  
Marschall B. Berkes ◽  
Milton T. M. Little ◽  
Nadine C. Pardee ◽  
Patrick C. Schottel ◽  
Lionel E. Lazaro ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humerus Fracture ◽  
Case Control Study ◽  
Proximal Humerus ◽  
Shoulder Girdle ◽  
Case Control ◽  
Open Reduction Internal Fixation ◽  
Humerus Fracture ◽  
Control Study

scholarly journals Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years

2012 ◽  
Vol 15 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Ki Won Lee ◽  
Young Joon Choi ◽  
Hyung Sun Ahn ◽  
Chung Hwan Kim ◽  
Jae Kwang Hwang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Humerus Fracture ◽  
Vas Score ◽  
Compression Plate ◽  
The Mean

PURPOSE: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated.MATERIALS AND METHODS: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle.RESULTS: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head.CONCLUSION: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

scholarly journals How Age and Gender Influence Proximal Humerus Fracture Management in Patients over Fifty

2021 ◽  
Author(s):  
Akshar H. Patel ◽  
J. Heath Wilder ◽  
Sione A. Ofa ◽  
Olivia C. Lee ◽  
Michael C. Iloanya ◽  
...  
Keyword(s):  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Age And Gender ◽  
Gender Influence ◽  
Fracture Management ◽  
And Gender

scholarly journals “Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

2021 ◽  
Vol 11 (8) ◽  
Author(s):  
Vivek M Sodhai ◽  
Chetan V Pradhan ◽  
Parag K Sancheti ◽  
Ashok K Shyam
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixator ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Treatment Strategies ◽  
Soft Tissue Injuries ◽  
Definitive Treatment

Introduction: Segmental tibia fractures with extensive soft tissue injuries are rare and surgical intervention is challenging with no definitive treatment strategies. Case Report: A 52-year-old man presented with closed right segmental tibia and fibula fracture with extensive blistering of skin caused due to road traffic accident. Distal pulses were palpable and there were no signs of compartment syndrome and other systemic injuries. In the presence of extensive blistering, a monoplanar external fixator was applied within 24 h of injury. 3 weeks later, skin condition was conducive for internal fixation, and closed intramedullary multi-locking nailing was performed using the external fixator for reduction. Fracture healed at 15 months and patient had an excellent functional outcome with full knee range of motion at 2-years follow-up without any complications. Conclusion: Fixator-assisted nailing is a simple, minimally invasive, and easily reproducible technique that is useful in reducing the fracture and preventing axial rotation of the intercalary segment minimizing the damage to the periosteal blood supply. Our case also highlights the importance of temporary external fixator in soft tissue healing and making the skin conducive for internal fixation. Keywords: Devascularization, fixator-assisted nailing, intercalary segment, rotational displacement, segmental tibial fracture.

scholarly journals The treatment of proximal humerus fracture using internal fixation with fixed-angle plates

2019 ◽  
Author(s):  
Patrick Ziegler ◽  
Sven Maier ◽  
Ulrich Stöckle ◽  
Markus Gühring ◽  
Fabian M. Stuby
Keyword(s):  
Internal Fixation ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Fixed Angle

scholarly journals Cost-effectiveness of Open Reduction and Internal Fixation Compared With Hemiarthroplasty in the Management of Complex Proximal Humerus Fractures

2018 ◽  
Vol 2 ◽  
pp. 247154921775145
Author(s):  
Robert J Thorsness ◽  
James C Iannuzzi ◽  
Edward J Shields ◽  
Katia Noyes ◽  
Ilya Voloshin
Keyword(s):  
Cost Effectiveness ◽  
Internal Fixation ◽  
Open Reduction ◽  
Retrospective Cohort ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Cost Effective ◽  
Humerus Fracture ◽  
Proximal Humerus Fractures ◽  
Humerus Fractures

Objectives To determine if open reduction and internal fixation (ORIF) is more cost-effective than hemiarthroplasty (HA) in the management of proximal humerus fracture. Design Retrospective cohort study with cost-effectiveness analysis. Setting Tertiary referral center in Rochester, NY. Patients/participants The records of 459 consecutive patients in whom a proximal humerus fracture was treated surgically at our institution between the years 2002 and 2012 were studied retrospectively. We identified 30 consecutive patients with a mean follow-up of 60.3 months (13.6–134.5 months) of which 15 patients underwent primary ORIF and another 15 underwent primary HA for the management of head-splitting fracture or fracture-dislocation of the proximal humerus. Intervention HA or ORIF for the management of proximal humerus fracture. Main outcome measurements SF-36 scores were converted to utility weights, and a cost-effectiveness model was designed to evaluated ORIF and HA. Results Given the baseline assumptions, ORIF was slightly more costly but also more effective (0.75 quality-adjusted life years [QALY] vs 0.67 QALY) than HA. The incremental cost-effectiveness ratio (ICER) was $5319/QALY for ORIF compared to HA, which is less than the cost-effectiveness standard utilized based on a willingness to pay of $50,000/QALY. Conclusions Compared to HA, ORIF is the more cost-effective approach for the surgical management of complex proximal humerus fractures. These data are limited by patient selection which would impact the relative utility scores. These results suggest that ORIF should be considered the preferable surgical approach given payer and patient perspectives. Level of Evidence: This is a Level III retrospective, cohort therapeutic study.

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