Early displacement of two part proximal humerus fractures treated with intramedullary proximal humeral nail

Rotman, Dani; Efrima, Ben; Yoselevski, Nadav; Gurel, Ron; Kazum, Efi; Maman, Eran; Goldstein, Yariv; Chechik, Ofir

doi:10.1016/j.jor.2019.11.027

Cited by 13 publications

(10 citation statements)

References 24 publications

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“…37 The screw-in-screw configuration contributed to prevent varus collapse and it provided better stability and the additional calcar screw, a positive effect when regarding to the failure load reached. 33,38 Due to the application of screw-in-screw and calcar screw, the mean decrease of NSA was 1.9°in our nail group, which was less than Nolan et al 18 with Polaris nail (8°) and Rotman et al 30 with MultiLoc nail (16.5°).…”

Section: Discussioncontrasting

confidence: 56%

“…Our study showed comparable intraoperative NSA, but much higher loss of NSA in the Plate Group. On the contrary, Rotman et al 30 reported severe loss of NSA in patients treated with MultiLoc, and no ascending calcar screw was seen in their pictures to support the medial column and increase the axial stability which was indispensable in fracture reconstruction and avoiding secondary displacement. 31 - 33 Biomechanical evaluation showed that two screws and a calcar screw were superior in most aspects to increase the stability.…”

Section: Discussionmentioning

confidence: 95%

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MutiLoc Nail Versus Philos Plate in Treating Proximal Humeral Fractures: A Retrospective Study Among the Alderly

Sun

et al. 2021

Geriatr Orthop Surg Rehabil

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Background Proximal humeral fractures (PHFs) account for 4–5% of all fractures in the elderly. There is still a controversy among the treatments in the displaced PHFs. Our aim was to explore the clinical outcome of PHFs with the treatment of MultiLoc nail or Philos plate in the elderly patients. Methods A total of 82 sustained elderly patients with PHFs were finally recruited between Dec 2016 and Dec 2017. 34 patients were treated with MultiLoc nail and 48 patients were treated with Philos plate. The demographics, fracture types, blood loss, operation time, union time, postoperative complications, visual analog scores (VASs), Constant scores, American Shoulder and Elbow Scores (ASESs), and neck-shaft-angle (NSA) between the two groups were compared. Results No differences were observed in the demographics, fracture types, VAS, Constant scores, and ASES scores between the two groups at final follow-up. Compared with the plate group, the blood loss, operation time, and union time were significantly lower in the nail group (all P < .05). The rate of general complications was 54.17% in the plate group, which was higher than that in the nail group (26.47%, P = .01). Three patients experienced reoperation in the plate group (3/48; 6.25%), but none in the nail group. Although there were no significant differences in intraoperative NSA between the two groups, the NSA at final follow-up in the nail group was much higher than the plate group (137.55 ± 5.53°vs 134.47 ± 5.92°, P = .02). Conclusions Multiloc intramedullary nail showed the similar effectiveness of final VAS, final Constant scores, and ASES scores in PHFs treatment with Philos plate. However, MultiLoc nail is superior to Philos plate in blood loss, operation time, complications, reoperation rate, and the change of NSA.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 95%

MutiLoc Nail Versus Philos Plate in Treating Proximal Humeral Fractures: A Retrospective Study Among the Alderly

Sun

et al. 2021

Geriatr Orthop Surg Rehabil

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“…However, it may damage the tissues and blood vessels of patients to different degrees [ 10 , 11 ]. While intramedullary nailing (IMN) is a less-invasive surgical procedure that has the advantages of reducing soft tissue damage, protecting the blood supply to the humerus, and shortening the operation time (OT) [ 12 , 13 ]. In this procedure, the intramedullary nail is inserted into the medullary cavity directly below the cartilage, and then, the proximal and distal locking screws are inserted through the auxiliary system [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intramedullary Nailing in the Treatment of Comminuted Proximal Humeral Fractures and Its Influence on Shoulder Joint Function Recovery

Lan

Xie

Que

et al. 2022

Journal of Healthcare Engineering

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In this paper, we have aimed to elucidate the therapeutic effect of intramedullary nailing (IMN) in treating comminuted proximal humeral fractures (CPHFs) and its influence on the recovery of shoulder joint function. For this purpose, 60 cases with CPHFs were selected, particularly from January 2020 to October 2021. In these cases, 28 cases were treated with a locking proximal humeral plate (LPHP) and assigned to the control (Con) group and the remaining 32 patients were treated with IMN and included in the research (Res) group. The therapeutic effect, surgical indicators, total complications, visual analogue scale (VAS) score, and postoperative shoulder joint function score were compared between the two arms. We observed that compared with the Con group, the effective rate in the Res group was higher while the operation time, intraoperative blood loss, and fracture healing time were shorter, the overall complication rate and VAS score were lower, and the postoperative shoulder joint function score was higher, all with statistical significance. The above results indicate that IMN is effective and safe in the treatment of CPHFs, which can validly reduce the discomfort of patients and facilitate the recovery of shoulder joint function.

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“…Recently, the intramedullary nail has become a promising alternative, as well. It is widely used for fixation of the proximal humeral fractures, with the obviously advantages of percutaneous insertion, decreased soft tissue disruption, and less operative time, in both young or elderly patients 17,18 . Its clinical outcomes and biomechanical strength have been manifested effective 3–5 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Application of Nail‐Plate Fixation in the Treatment of Complex Proximal Third Humeral Fracture: A Case Report and Literature Review

2022

Orthopaedic Surgery

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BackgroundProximal humeral fractures with increasing incidence are common over the past decades. Among them, the complicated and displaced ones, especially combined with the proximal third humeral shaft fractures, need to be treated surgically. Humeral intramedullary nail and locking plate are the most frequently used options. However, few studies address the application of nail‐plate combination for management.Case presentationA 49‐year‐old man struck by a car was referred to our emergency trauma center. The X‐ray and three‐dimensional computed tomography (CT) showed a complex proximal humeral fracture with proximal third shaft fracture. No evidence of other associated injuries and neurovascular symptom of the injured left upper limb was shown by physical examination. Nail‐plate fixation was performed to restore the anatomic integrity of proximal humerus. The injured arm was maintained in a broad arm sling for 14 days after surgery. The active as well as positive movements under the instruction were encouraged as long as the pain could be tolerated from postoperative day 2. One year after the surgery, the fracture was healed, and the patient regained normal shoulder motion. The good clinical outcomes were obtained by application of nail‐plate fixation to treat complex proximal third humeral shaft fractures. Thus, this surgical intervention could be performed as an alternative.

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Early displacement of two part proximal humerus fractures treated with intramedullary proximal humeral nail

Cited by 13 publications

References 24 publications

MutiLoc Nail Versus Philos Plate in Treating Proximal Humeral Fractures: A Retrospective Study Among the Alderly

MutiLoc Nail Versus Philos Plate in Treating Proximal Humeral Fractures: A Retrospective Study Among the Alderly

Efficacy of Intramedullary Nailing in the Treatment of Comminuted Proximal Humeral Fractures and Its Influence on Shoulder Joint Function Recovery

Clinical Application of Nail‐Plate Fixation in the Treatment of Complex Proximal Third Humeral Fracture: A Case Report and Literature Review

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