ObjectiveTo evaluate patients diagnosed with posterior four-part fracture-dislocations of the proximal humerus, that were surgically treated with osteosynthesis, regarding their clinical and functional outcomes.MethodsA prospective observational study of eight patients from the same hospital institution in the interior of São Paulo State (Brazil), through individual interviews using the UCLA, DASH, and Constant international scores. The active movements included in the scores plus the range of motion of the affected and non-affected limb were measured. The affected shoulder's radiographs were requested to verify bone conditions and the fixation of the osteosynthesis.ResultsThe rating of eight patients by the international scores indicated that seven of the eight patients presented good clinical and functional evolution of the affected limb; this represents 87.5% of the evaluated individuals.ConclusionSurgical treatment with osteosynthesis performed during the acute period (
OBJECTIVE: To carry out a biomechanical study of four techniques for fixation of four-part humeral head fractures. METHODS: The fracture was reproduced in 40 plastic humeri, divided into groups of ten according to the fixation technique, each one employing different fixation resources, in different configurations. The humeral models were mounted on an aluminum scapula, with leather straps simulating the rotator cuff tendons, and submitted to bending and torsion tests in a universal testing machine, using relative stiffness as an evaluation parameter. Assemblies with intact humeri were analyzed for comparison. RESULTS: The biomechanical behavior of the fixation techniques varied within a wide range, where the assemblies including the DCP plate and the 4.5mm diameter screws were significantly more rigid than the assemblies with the Kirschner wires and the 3.5mm diameter screws. CONCLUSION: The four fixation techniques were able to bear loads compatible with the physiological demand, but those with higher relative stiffness should be preferred for clinical application. Laboratory investigation
.
Foi avalida a resistência à avulsão de âncoras rosqueadas de 3,5 e 4,5 mm de diâmetro, utilizando fêmores de suínos frescos congelados como modelo e uma máquina universal de ensaios. O trocânter maior era ressecado e as âncoras, montadas com um cabo de aço flexível para permitir a fixação na máquina de ensaio, eram inseridas no osso esponjoso próximo à borda da cabeça femoral, a 30°, 60° e 90° com o eixo longitudinal da diáfise femoral. Os espécimes eram fixados na máquina de ensaio e a tração era aplicada continuamente, à razão de 1 mm/minuto até que ocorresse a falha da montagem. Dados referentes à carga máxima aplicada, carga no limite da proporcionalidade, rigidez e resiliência foram registrados e comparados (p<0.05). Os resultados mostraram que a carga máxima, a carga no limite da proporcionalidade e a resiliência foram significantemente maiores (p=0,04, p=0,01 e p=0,02, respectivamente) para as âncoras de 4,5 mm de diâmetro inseridas a 60°, comparado aos outros ângulos e às âncoras de 3,5 mm em qualquer ângulo. Carga no limite da proporcionalidade e rigidez não diferiram significantemente para as âncoras de ambos os diâmetros e os diferentes ângulos de inserção.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.