Ender Nailing for Unstable Surgical Neck Fractures of the Humerus in Elderly Patients

Ogiwara, Naoshi; Aoki, Mitsuhiro; Okamura, Kazuhiko; Fukushima, Sunao

doi:10.1097/00003086-199609000-00021

Cited by 33 publications

(24 citation statements)

References 8 publications

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“…[7][8][9][10] All techniques have varying rate of complications like cutout or back-out of the screws and plates, loss of fixation, fracture distal to the plate. [13][14][15] Locking anatomical plate fixation offers many advantages compared to non-locking plates.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] Various complications like nonunion at fracture site, avascular necrosis of head of humerus, nail migration, rotator cuff impingement syndrome, cut out of implants can occur. 11,12 PHILOS have been designed to improve internal fixation in elderly patients where bones in whom bones are severely osteoporotic and help prevent complications.…”

Section: Introductionmentioning

confidence: 99%

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Outcome of locking plate fixation for proximal humerus fractures

Rohra

Chokshi

Sanghavi³

2016

Int J Res Orthop

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Background: The objective of the study was to evaluate functional outcome of open reduction and internal fixation with proximal humeral internal locking system (PHILOS) plate for proximal humerus fractures.Methods: We reviewed 30 patients who underwent open reduction and internal fixation with PHILOS plate between the years 2010 to 2015. There were 23 men and7 women with a mean age of 36 years (range 20-64).There were 22 patients in the age group of <60 years and 8 patients in the age group of >60 years. According to Neer classification system, 12, 11 and 4 patients had2-part, 3-part, and 4-part fractures, respectively and 2 patients had 4-part fracture dislocation. All surgeries were carried out at our tertiary care trauma center. Functional evaluation of the shoulder at final follow-up was done using Neer’s Evaluation Criteria.Results: The mean follow-up period was 20 months (range 14-40 months). All fractures united clinically and radio logically. The mean time for radiological union was 13.2 weeks (range 9-26 weeks).At the final follow-up the mean Neer’s Evaluation Criteria was 90 (range 76-100). The results were excellent in 17patients, Satisfactory in 8 patients, Unsatisfactory in 4 patients and Failure in 1 patient. During the follow-up, 3 cases of varus malunion, 1 case of failure of fixation were noted. No cases of AVN, hardware failure, locking screw loosening, infection or nonunion were noted.Conclusions: PHILOS provides stable fixation in proximal humerus fractures. In order to prevent the complications like avascular necrosis, knowledge of anatomy and vascular supply of head of humerus and good surgical dissection to preserve vascularity of humeral head is important.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcome of locking plate fixation for proximal humerus fractures

Rohra

Chokshi

Sanghavi³

2016

Int J Res Orthop

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“…Different techniques have been described for the fixation of comminuted and displaced proximal humerus fractures. [8][9][10][11] All these techniques have been associated with a varying rate of complications such as Locking periarticular plate fixation offers more advantages compared to many implants and have been shown to be superior to non-locking plates. [19][20][21] Meticulous care must be taken to preserve the overlying soft tissues during open reduction and internal fixation since damage to these soft tissues may disturb the vascularity of fracture fragments.…”

Section: Discussionmentioning

confidence: 99%

“…Kwire, TBW, plating, nailing, arthroplasty) for managing the more complex fracture is a testament to the lack of clear superiority of any one method. [5][6][7][8][9] Most of these techniques have been associated with complications related to hardware failure, osteonecrosis, nonunion, malunion, rotator cuff impingement. 10 Proximal humeral locking plates such as proximal humeral interlocking plate (Philos, Synthes, Switzerland) offer several potential advantages in the treatment of these injuries.…”

Section: Introductionmentioning

confidence: 99%

Study of operative management of proximal humerus fracture treated with locking plates

et al. 2016

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Background: This study was undertaken to evaluate the efficacy of Philos plate and to specifically study the clinical outcome of the patient treated with Philos plate for proximal humerus fracture on the radiological head shaft angle basis.Methods: 40 cases of proximal humerus fracture fixed by using Philos plate were reviewed.Results: Average constant shoulder score as Neer type-3 fracture is 83.8% and for type- 4 part fracture is 86%. Average radiological union was seen at 10.2 weeks. There was no major difference in clinical and radiological union. Conclusions: Good functional outcome with Philos plate irrespective of fracture type was obtained.

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“…Conservative management is the standard for stable and undisplaced fractures. Several surgical options are available for displaced proximal humeral fracture treatment, while a lack of consensus exists regarding the ideal surgical method for these challenging fractures [3][4][5][6][7][8][9]. Open reduction with internal fixation applying locking plates is the worldwide treatment choice, especially in poor bone quality patients [10,11].…”

Section: Introductionmentioning

confidence: 99%