Resultados do tratamento das fraturas do terço proximal do úmero com placas de bloqueio

Abstract

Objective: To analyze the clinical results after proximal humerus fracture fixation using blocked plates and screws. Material and Methods: In the period from November 2003 to January 2008, the authors treated 33 patients with 34 fractures of the proximal humerus. The mean age was 57 years old (33 to 86 years), 14 males and 19 females. All patients were operated in the acute phase, within the first week after the trauma. The patients were treated with open reduction and internal fixation using locking plates. The surgical technique, implants, period of immobilization and rehabilitation protocol were the same for all the patients. Results: The mean follow-up period was 24 months (8 to 60 months). The functional evaluation was based in the UCLA score. Good and excellent results were present in 31 (91.2%) of the patients and 3 (8.8%) of them presented poor results. Conclusions: As a conclusion, the locking plate system of fixation was considered efficient for the treatment of proximal humerus fractures.

Posterior four-part fracture-dislocations of the proximal humerus: clinical and functional evaluation of osteosynthesis treatment

“…The internal fixation with LP and screws offers greater stability, favoring early mobility of the affected limb. 4 However, various other methods of osteosynthesis are also capable of providing stability and allowing early mobility. 20 Different osteosynthesis methods provide different degrees of stability, but show similar functional clinical results.…”

“…In the present study, different osteosynthesis techniques were used, such as securing sutures, 23 , 24 KW and tension-band, 25 and LP, 4 depending of the material available for each case, which is related to financial cost. However, all patients underwent surgical treatment in accordance with the concepts of minimally invasive osteosynthesis, i.e ., early surgical intervention, minimal soft tissue injury, careful manipulation of the fragments, fracture stabilization, and early rehabilitation.…”

“…Fractures of the proximal humerus account for 4% to 10% of all fractures; the most common trauma mechanism is a fall from the patient's own height. 4 …”

Evaluation of the Complications of Surgical Treatment of Fractures of the Proximal Extremity of the Humerus Using a Locking Plate

“…In a review of the literature, we found rates of occurrence of subacromial impact ranging from zero to 10.3% 4 , 6 , 12 , 27 . According to some authors, the plate should be positioned between five and eight millimeters from the apex of the greater tubercle; if not, a mechanical impact on the acromion might occur when the shoulder is raised 9 , 27 , 28 . In our study, we observed five cases of impact caused by placement of the plate in positions that were too high, i.e.…”

Treatment of proximal humeral fractures using anatomical locking plate: correlation of functional and radiographic results

“…The most commonly used surgical techniques are: closed reduction and fixation with pins or percutaneous screws, open reduction and internal fixation with plate and screws or with tension band, intramedullary nails, and hemiarthroplasty. 2 , 9 …”