Fixation Techniques for Intraarticular Proximal Humeral Fractures

Abstract

Introduction. To date, the proposed directions of osteosynthesis of intra-articular fractures of the butt (bone osteosynthesis with LCP plates, intramedullary osteosynthesis PHN) do not reduce the risk of ANGPC and do not reduce the number of non-joints; with the accumulation of information on the results of hemi- and total endoprosthetics of the shoulder joint, an increasing number of complications specific to this method and a small patient satisfaction are revealed. In this regard, there is a need to use the method of osteosynthesis with an element of stimulation of reparative osteogenesis for the prevention of ischemic changes in the head of the humerus. Goal. To improve the results of surgical treatment of intra-articular fractures of the proximal humerus on the basis of the development of a new technique of osteosynthesis using reparative stimulation with a non-free musculoskeletal graft from the cranial process of the scapula.Material and methods. The material for the study was the analysis of the results of treatment of 67 cases of patients with intra-articular fractures of the proximal humerus of categories 11-C1 and 11-C2. In the databases of electronic information resources PubMed, eLibrary, the analysis of literary data on search words was carried out. Results. According to the data obtained during the study, the functional results of the group of patients operated using the method of reparative stimulation with a non-free musculoskeletal graft from the cranial process of the scapula are statistically higher than the results of the control group. Taking into account the peculiarities of the blood supply of the POPC, indications for the types of osteosynthesis of intra-articular fractures (bone osteosynthesis or bone osteosynthesis with transplantation of NCMT from the cranial process of the scapula) were established. Conclusion. In the treatment of intra-articular fractures of the proximal humerus, the operative method of bone osteosynthesis is preferred. The use of autoplasty with a non-free musculoskeletal graft from the cranial process of the scapula reduces the risk of developing post-traumatic aseptic necrosis of the head.