Fractures of the proximal humerus are among the most common, especially among patients of older age groups. Often these fractures require surgical treatment. However, comminuted fracture, osteoporosis make it difficult to carry out osteosynthesis. This article describes a clinical case of successful treatment of a fracture of the surgical neck of the humerus in a patient with osteoporosis. Surgical intervention was carried out on the basis of the developed method of osteosynthesis of a fracture of the surgical neck of the humerus (RF Patent no. RU 2749296 C1). To fix the fragments we used a T-shaped plate, screws and a wire loop-tie passed through the head of the humerus. Carrying out the metal structure extramedullarly through the fracture line minimizes additional intraoperative damage and creates a reliable fixation of fragments without the risk of loosening and migration of the metal structure, which allows this method to be used in the osteoporotic process in the head of the humerus. Obtained results of the patient's treatment are good: restored function and amplitude of movement in the shoulder joint, no pain syndrome. The presented clinical case demonstrates the expediency and effectiveness of osteosynthesis according to our proposed method for fractures of the proximal humerus on the background of osteoporosis.
The article presents an observation of the successful treatment of a patient with a fracture of the surgical neck of the right humerus against the background of osteoporotic lesions of the bone skeleton. This patient was initially underwent osteosynthesis with a titanium T-plate and screws, however, 2 weeks later, the metal structure migrated and the cancellous substance of the humerus head was severely destroyed, which made it difficult to carry out repeated resynthesis. We have proposed and tested a new method of osteosynthesis of fractures of the surgical neck of the shoulder using a titanium plate and a cerclage loop. The presented clinical observation demonstrates the feasibility of performing osteosynthesis according to our proposed method in patients with severe osteoporosis, when other methods of osteosynthesis are ineffective, and endoprosthetics of the humerus head is unavailable due to the burdened somatic status of the patient and the inaccessibility of this operation in small hospitals in the country.
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