Intramedullary Plating of Complex Proximal Humerus Fractures: A Case Series

Publish Year: 1403
نوع سند: مقاله ژورنالی
زبان: English
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JR_TABO-12-6_004

تاریخ نمایه سازی: 16 خرداد 1403

Abstract:

Objectives: To assess fracture union rates using novel intramedullary plate technique. Post-operative humeral neck-shaft angles, patient range of motion and complication profile were secondary outcomes of interest.Methods: Single surgeon, retrospective case series of surgical technique at major trauma centre in Scotland. A ۲.۰mm mini-fragment plate was secured to the humeral head to act as an intramedullary strut during fixation in complex proximal humerus fractures. Fracture union and neck-shaft angle were assessed radiologically, whilst range of motion and complication profiles were assessed clinically.Results: Twelve patients were followed up for an average of ۱۰ months post-operatively. All achieved bony union with a mean neck-shaft angle of ۱۲۸°. Mean range of motion values were ۱۰۰° forward elevation, ۸۳° abduction, ۶۰° internal rotation and ۳۷° external rotation. Four patients required further surgical intervention- two for hardware prominence, one for adhesive capsulitis and one for subsequent rotator cuff failure. There were no cases of avascular necrosis or infection.Conclusion: This novel technique addresses the established biomechanical propensity of proximal humerus fractures to fail in varus collapse and screw cut-out. This method provides an alternative to arthroplasty in the most severe proximal humerus fractures and is readily adopted via standard orthopaedic kit. Level of evidence: IV

Authors

Stephen Mc. Donald

Dept of Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, Scotland

Andrel Yoong

Dept of Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, Scotland

Piotr Skrzypiec

Dept of Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, Scotland

Alan Johnstone

Dept of Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, Scotland

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