Impacted valgus fractures of the proximal humerus

Ribeiro, Fabiano Rebouças; Takesian, Fernando Hovaguim; Bezerra, Luiz Eduardo Pimentel; Filho, Rômulo Brasil; Júnior, Antonio Carlos Tenor; Costa, Miguel Pereira da

doi:10.1016/j.rboe.2016.01.004

Cited by 8 publications

(8 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4e7 Based on previous reports it appears that, regardless of the technique of fixation, the functional outcome of an osteosynthesis may be relatively good if the blood supply to the humeral head is preserved. 5,8,9 Hardware problems from usage of locking plates are however a quite common reason for reoperation of PHF's, in some reports up to 30%, especially if avascular necrosis ensues. 7,10e12 At our institution, we therefore have used only non-absorbable sutures for fixation of valgus impacted, PHFs, based on a description by Bigliani 1990.…”

Section: Introductionmentioning

confidence: 99%

Solely sutures is a reliable fixation for valgus-impacted proximal humeral fractures

Scheer¹,

Tillander²,

Dånmark³

et al. 2021

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

Valgus impacted proximal humeral fractures with substantial displacement may severely compromise shoulder function and open reduction can therefore be considered. Internal fixation hardware may eventually however constitute problems. In a small subset of these fractures, in which there is no medial comminution and intact blood supply it is possible to use a least possible fixation method with solely sutures through the tendons of the rotator cuff and the shaft as described by Bigliani 1990. The aim of the present study was to investigate the outcome of this fixation method in a retrospective series of patients. Methods: Twenty-seven patients, 23 women and 4 men, with a mean age of 66 years (53e83) and minimum follow-up time of 2 years (2e11 years) accepted follow-up with standard shoulder radiographs and 22 were examined with Oxford Shoulder Score (OSS), Constant-Murley (CM) shoulder score and Numeric Rating Scale for pain (NRS). Reoperations or adverse events were recorded. Results: The median OSS was 45 (range 5e48) and CM 63 (range 21e98). The relative CM score was 81% of the uninjured side and median NRS 0 (range 0e5). No reoperations were undertaken. One patient had a complete avascular necrosis (AVN), 3 patients had a partial AVN of the humeral head and two a partial resorption of the greater tuberosity. Conclusion:The use of sutures only for fixation of displaced valgus-impacted proximal humeral fractures provided a relatively reliable outcome with good functional scores and no reoperations. There appears to be no need for the use of hardware for fixation of this rare subset of fractures.

show abstract

Section: Introductionmentioning

confidence: 99%

Solely sutures is a reliable fixation for valgus-impacted proximal humeral fractures

Scheer¹,

Tillander²,

Dånmark³

et al. 2021

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

show abstract

“…A fracture along the anatomic neck with a glenohumeral joint dislocation can cause damage to both the anterior and posterior humeral circumflex arteries. In valgus impacted fractures, the integrity of the posteromedial periosteum of the calcar region is often maintained, potentially sparing the posterior circumflex artery 8 .…”

Section: Etiology Of Humeral Head Avnmentioning

confidence: 99%

“…The anterior circumflex artery enters the epiphysis at the lateral and superior aspects of the intertubercular groove and supplies the most epiphysis as the intraosseous arcuate artery 6,7 . The posterior circumflex artery passes through the posteromedial periosteum of the calcar region 8 . Historically, the anterior circumflex artery was believed to be the main blood supply; however, newer studies suggest that it actually may be the posterior circumflex humeral artery 9 .…”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Humeral Head Avascular Necrosis

et al. 2023

View full text Add to dashboard Cite

Avascular necrosis (AVN) of the humeral head is the result of ischemic injury to the epiphyseal bone leading to humeral head collapse and arthritis.Common causes include trauma, chronic corticosteroid use, or systemic disease processes, such as sickle cell disease, systemic lupus erythematosus, or alcohol abuse.Nonoperative treatment consists of risk factor management, physical therapy, anti-inflammatory medications, and activity modification.Surgical treatment options include arthroscopic debridement, core decompression, vascularized bone grafts, and shoulder arthroplasty.

show abstract

“…Based on the Ilizarov circular fixator (ICF), a previous study [ 3 ] applied the Stewart platform and Charles theory to the field of orthopedics, and combined these with computer software to invent the Taylor 3D space frame. Taylor 3D external fixation (TSF) is a good complement to the deficiencies of the ICF for multidimensional planar fractures and deformity correction.…”

Section: Introductionmentioning

confidence: 99%

Application of Intelligent Computer-Assisted Taylor 3D External Fixation in the Treatment of Tibiofibular Fracture: Retrospective Case Study

Sheng

et al. 2021

JMIR Med Inform

View full text Add to dashboard Cite

Background With the development of modern society, severe and complex tibial fractures caused by high-energy injuries such as traffic accidents have gradually increased. At present, the commonly used methods for the treatment of tibial fractures include plate fixation, intramedullary nail fixation, and external fixation. Most of these fractures are open wounds with severe soft tissue injury and wound contamination, and some involve bone defects, which makes internal fixation treatment difficult. Objective This study aims to explore the use of intelligent computer-assisted Taylor 3D external fixation for the treatment of tibiofibular fractures. Methods In total, 70 patients were included and divided into the Taylor 3D external fixation (TSF) group (28 patients with severe tibial fractures treated with TSF) and the internal fixation group (42 patients with complicated tibiofibular fractures treated by internal fixation). After the treatment, the follow-up evaluation of TSF for the treatment of tibiofibular fractures noted the incidence of complications, as well as the efficacy and occurrence of internal fixation for the treatment of tibial fractures in our hospital. Results The results showed that TSF was superior to orthopedics in the treatment of tibiofibular fractures in terms of efficacy and complications. Conclusions TSF for the treatment of tibiofibular fractures is more effective than internal fixation and the incidence of complications is low. This is a new technology for the treatment of tibiofibular fractures that is worthy of clinical promotion.

show abstract

Impacted valgus fractures of the proximal humerus

Cited by 8 publications

References 13 publications

Solely sutures is a reliable fixation for valgus-impacted proximal humeral fractures

Solely sutures is a reliable fixation for valgus-impacted proximal humeral fractures

Humeral Head Avascular Necrosis

Application of Intelligent Computer-Assisted Taylor 3D External Fixation in the Treatment of Tibiofibular Fracture: Retrospective Case Study

Contact Info

Product

Resources

About