Antegrade Nailing Versus Locking Plate of 2-and 3-Part Proximal Humerus Fractures

Gomes, Gustavo Remigio; Maciel, Rafael Almeida; Neto, José Inácio de Almeida; Toledo, Daniel Carvalho de; Machado, Carla Jorge; Bomfim, Leonidas DE Souza

doi:10.1590/1413-785220223005e256113

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…Gomes GR .et al compared the proportions of complications and radiographic findings of Osteosynthesis of 2- and 3-part proximal humerus fractures with antegrade MultiLoc nail and locking plate. The nail group had less change in the postoperative cervicodiaphyseal angle [ 18 ]. MultiLoc nail with cement augmentation is a viable option for treating proximal humerus pathological fracture, providing less blood loss, rigid fixation and better pain relief [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Straight intramedullary MultiLoc nails for displaced proximal humeral fractures: health status, radiographic results, clinical outcome, and complications

Chen,

Zhang,

Zhu

et al. 2024

BMC Musculoskelet Disord

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Background The treatment of the displaced proximal humerus fractures (PHF) still facing a lot of unsolved problems. The aim of this study was to evaluate the clinical effect of MultiLoc nails for the treatment of PHF and present outcomes of patients with different Neer’s classification and reduction quality. Methods Adult patients with PHFs were recruited and treated with MultiLoc nail. Intraoperative data, radiographic and functional outcomes, as well as occurrence of postoperative complications were assessed. Results 48 patients met inclusion and exclusion criteria and were included in this study. The DASH Score were 32.2 ± 3.1 points at 12 months, and 37.3 ± 2.5 points at the final follow-up. The mean ASES score at 12 months and final follow-up were 74.4 ± 6.2 and 78.8 ± 5.1, respectively. The mean CM Score in all 48 patients reached 68 ± 6.4 points at the final follow-up, relative side related CM Score 75.2 ± 7.7% of contralateral extremity. The incidence rate of complications was 20.8%. Patients with fracture mal-union, adhesive capsulitis were observed but no secondary surgeries were performed. There was no significantly difference of DASH Score 12 months after surgery and at the last follow-up among patients with different Neer’s classification or reduction quality. However, functional outcomes such as ASES score and CM score were significantly influenced by severity of fracture and the quality of fracture reduction. Conclusions Our study demonstrated that MultiLoc nails is well suited for proximal humeral fractures, with satisfactory health status recovery, good radiographic results, positive clinical outcomes and low rates of complications. The treatment for four part PHF still faces great challenges. Accurate fracture reduction was an important factor for good functional result.

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Section: Introductionmentioning

confidence: 99%

Straight intramedullary MultiLoc nails for displaced proximal humeral fractures: health status, radiographic results, clinical outcome, and complications

Chen,

Zhang,

Zhu

et al. 2024

BMC Musculoskelet Disord

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Progress and Thinking on the Treatment of Proximal Humeral Fracture

王

2023

ACM

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A Standardized Operative Protocol for Fixation of Proximal Humeral Fractures Using a Locking Plate to Minimize Surgery-Related Complications

Kwisda

Imiolczyk

et al. 2023

JCM

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The current literature suggests that up to 55% of complications after plate osteosynthesis treatment for patients with proximal humerus fractures are attributed to the surgical procedure. The hypothesis of this study was that a standardized surgical protocol would minimize surgery-related adverse events. This prospective cohort study included 50 patients with a mean age of 63.2 (range 28–92) years treated by one single surgeon using a previously published standardized surgical protocol. Clinical and radiological follow-up examinations were conducted for up to 24 months using Constant–Murley Score (CS), Subjective Shoulder Value (SSV) and radiographs in true anteroposterior, axial and y-view. Finally, CS was 73.9 (standard deviation [SD]: 14.0) points (89% compared to the uninjured shoulder), and SSV was 83.3% (SD: 16.7) at two years of follow-up. Postoperative radiologic evaluation revealed no primary surgical-related or soft-tissue-related complications (0%). The main complications were secondary, biological complications (20%), largely represented by avascular necrosis (8%). Eight patients underwent revision surgery, mainly for implant removal. In addition, a total of four patients were revised using a hemiarthroplasty (n = 2), reverse shoulder arthroplasty (n = 1) or re-osteosynthesis. The use of our standardized surgical technique on proximal humerus fractures improves fixation with regard to primary stability and prevents primary, surgical-technique-related complications. The subjective grading of a high level of difficulty surgery was associated with more complications.

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Antegrade Nailing Versus Locking Plate of 2-and 3-Part Proximal Humerus Fractures

Cited by 3 publications

References 27 publications

Straight intramedullary MultiLoc nails for displaced proximal humeral fractures: health status, radiographic results, clinical outcome, and complications

Straight intramedullary MultiLoc nails for displaced proximal humeral fractures: health status, radiographic results, clinical outcome, and complications

Progress and Thinking on the Treatment of Proximal Humeral Fracture

A Standardized Operative Protocol for Fixation of Proximal Humeral Fractures Using a Locking Plate to Minimize Surgery-Related Complications

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