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[Untitled]
- Source :
- BMC Surgery.
-
Abstract
- Complex proximal humerus fractures with metaphyseal comminution remain challenging regarding reduction and stability. In most fracture patterns the hard bone of the bicipital groove remains intact. In this case series, we describe a novel technique of hybrid double plate osteosynthesis of complex proximal humerus fractures with metaphyseal comminution. In randomly chosen shoulder specimens and synthetic bones, pilot studies for evaluation of the feasibility of the technique were performed. Between 4/2010 and 1/2012 10 patients underwent hybrid double plate osteosynthesis. Seven patients (4 male, 3 female, mean age was 50 years (range 27–73)) were available for retrospective analysis. Based on plain radiographs (anterior-posterior and axial view), the fractures were classified according to the Orthopaedic Trauma Association classification (OTA) and by descriptive means (head-split variant (HS), diaphyseal extension or comminution (DE)). Follow-up radiographs demonstrated complete fracture healing in six patients and one incomplete avascular necrosis. None of the patients sustained loss of reduction. Three patients where reoperated. The medium, not adapted, Constant score was 80 Points (58–94). Patients subjective satisfaction was graded mean 3 (range: 0–6) in the visual analog scoring system (VAS). The technique of hybrid double plate osteosynthesis using the bicipital groove as anatomic landmark may re-establish shoulder function after complex proximal humerus fractures in two dimensions. Firstly the anatomy is restored due to a proper reduction based on intraoperative landmarks. Secondly additional support by the second plate may provide a higher stability in complex fractures with metaphyseal comminution.
- Subjects :
- 030222 orthopedics
medicine.medical_specialty
business.industry
Shoulder Fracture
Radiography
medicine.medical_treatment
Dentistry
030208 emergency & critical care medicine
Avascular necrosis
General Medicine
Bone healing
medicine.disease
Surgery
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
Plate osteosynthesis
Bicipital groove
Bone plate
Medicine
business
Reduction (orthopedic surgery)
Subjects
Details
- ISSN :
- 14712482
- Database :
- OpenAIRE
- Journal :
- BMC Surgery
- Accession number :
- edsair.doi...........a57ad1fca606936d1127dca2529317eb