Biological osteosynthesis of complex proximal humerus fractures: surgical technique and results from a prospective single center trial

Gavaskar, Ashok S.; Muthukumar, Sai; Chowdary, Naveen

doi:10.1007/s00402-009-1028-0

Cited by 17 publications

(10 citation statements)

References 23 publications

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“…Thus, it is relatively easy to perform a reduction of a large greater tuberosity fragment under direct vision and significantly reduces the intra-operative time. These findings were in accordance to previous reports [11,19,23,28]. …”

Section: Discussionsupporting

confidence: 94%

“…The complication rate of the MIPO group was less than 12%, which is comparable to previous reports [21,23,30,31,38]. In the literature, the main complications with LCP are implant-related, including impingement, intra-articular screw perforation and the proximal screw loosening [21,22,31,33,38].…”

Section: Discussionsupporting

confidence: 80%

“…To insert distal screws, a distal incision was made 7 cm distal to the acromion and was approximately 2.5-3.5 cm long (Figure 1E). In most cases, good reduction was achieved by applying axial traction on the humerus and pulling the rotator cuff [6,8,22,23,33]. In some cases, indirect reduction techniques, such as ligamentotaxis, were used.…”

Section: Methodsmentioning

confidence: 99%

“…The LCP was placed proximally below the apex of the greater tuberosity to maintain reduction. If non-absorbable sutures were used, they were secured to the suture wires holes in the LCP [6,11,16,19,21-23,26,28,33]. The plate was anchored proximally with multiple angled stable screws into the humeral head fragment.…”

Section: Methodsmentioning

confidence: 99%

“…The plate was anchored proximally with multiple angled stable screws into the humeral head fragment. After removing the aiming arm, the non-absorbable sutures were tightened to the LCP [21-23]. …”

Section: Methodsmentioning

confidence: 99%

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Minimally invasive plate osteosynthesis with a locking compression plate is superior to open reduction and internal fixation in the management of the proximal humerus fractures

Lin

Xiao

et al. 2014

BMC Musculoskelet Disord

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BackgroundThe use of minimally invasive plate osteosynthesis (MIPO) via anterolateral deltoid splitting has good outcomes in the management of proximal humerus fractures. While using this approach has several advantages, including minimal soft tissue disruption, preservation of natural biology and minimal blood loss, there is an increased risk for axillary nerve damage. This study compared the advantages and clinical and radiological outcomes of MIPO or open reduction and internal fixation (ORIF) in patients with proximal humerus fractures.MethodsA matched-pair analysis was performed, and patient groups were matched according to age (±3 years), sex and fracture type. Forty-three pairs of patients (average age: MIPO, 63 and ORIF, 61) with a minimum follow-up of 12 months were enrolled in the study group. The patients were investigated radiographically and clinically using the Constant score.ResultsThe MIPO technique required less surgery time and caused less blood loss compared to ORIF (p < 0.01). In addition, MIPO required a smaller incision, resulted in less scarring, and was cosmetically more appealing and acceptable to female patients than ORIF. Following MIPO, patients had better functional results at 3 and 6 months, with better outcomes, less pain, higher satisfaction in activities of daily living, and a higher range of motion when compared to ORIF (p < 0.05). Fracture configuration, according to the AO/ASIF(Association for the Study of Internal Fixation) fracture classification, did not significantly influence the functional results. The complication rate was comparable between both groups.ConclusionThe use of MIPO with a locking compression plate in the management of proximal humerus fractures is a safe and superior option compared to ORIF.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 80%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Minimally invasive plate osteosynthesis with a locking compression plate is superior to open reduction and internal fixation in the management of the proximal humerus fractures

Lin

Xiao

et al. 2014

BMC Musculoskelet Disord

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Proximale Humerusfraktur

Krettek

Wiebking

2011

Unfallchirurg

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Despite the fact that proximal humerus fractures represent one of the most frequent types of all fractures, the quality of evidence is poor although it has improved in recent years. It is widely agreed in the literature that nondisplaced fractures can be treated conservatively with good outcome. Two recent prospective randomized studies have shown that this also applies to displaced three- and four-part fractures.The results of fixed-angle plate osteosynthesis are also not superior to conservative management in complex displaced fractures in the elderly and in many aspects are even worse. Fixed-angle plate osteosynthesis has not fulfilled expectations. High rates of complications and revision surgeries as well as moderate functional results have been demonstrated in numerous studies.Conventional fracture prostheses or inverse prostheses are solutions fo complex not reducible and/or retainable. Also for the dislocated 4-part fracture of the patient above 60 ears no general advantages of the joint replacement compared to conservative treatment could be shown in a recent scandinavian prospective randomized clinical trial.

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Lessons learned from treating patients with unstable multifragmentary fractures of the proximal humerus by minimal invasive plate osteosynthesis

Cho

Choo

et al. 2015

Arch Orthop Trauma Surg

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Biological osteosynthesis of complex proximal humerus fractures: surgical technique and results from a prospective single center trial

Cited by 17 publications

References 23 publications

Minimally invasive plate osteosynthesis with a locking compression plate is superior to open reduction and internal fixation in the management of the proximal humerus fractures

Minimally invasive plate osteosynthesis with a locking compression plate is superior to open reduction and internal fixation in the management of the proximal humerus fractures

Proximale Humerusfraktur

Lessons learned from treating patients with unstable multifragmentary fractures of the proximal humerus by minimal invasive plate osteosynthesis

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