Indirect Reduction Technique in Proximal Humeral Fractures Stabilized by Locking Plates

Abstract

Background: Indirect reduction technique offers a valid option in the treatment of proximal humerus fracture. The purpose of this study is to evaluate the functional outcome and the complication rate after indirect reduction and internal fixation of unstable proximal humeral fractures with use of a locking plate. Methods: Twenty four patients with acute proximal humerus fracture were managed with indirect reduction and internal fixation with a locking plate. The mean follow-up period was 15.5 months. Results:The anatomical reduction of the medial cortex buttress was seen in 16 patients (66%) of the Group A and the non-anatomical reduction was seen in 8 patients (33%) of the Group B. Mean union time was 3.2 ± 1.9 months; it was 2.2 ± 0.6 months in the Group A and 5.3 ± 2.2 months in the Group B (p < 0.05). In our series, there were 6 cases of complications and these include 2 cases of varus malunion, 2 cases of shoulder stiffness, 1 case of heterotrophic ossification, 2 cases of screw perforation and 1 case of impingement. Conclusions: We conclude from our studies that indirect reduction and internal fixation using locking plate for acute proximal humerus fracture can give good results with bony union and predictable good overall functional outcome. If the medial cortex buttress is well maintained, a better anatomical reduction would be achieved, the union would be prompted, the pain would be further reduced and the range of the motion would be recovered more promptly. (Clin Shoulder Elb 2014;17(1):2-9)

Conventional plate fixation method versus pre-operative virtual simulation and three-dimensional printing-assisted contoured plate fixation method in the treatment of anterior pelvic ring fracture

“…Moreover, the precontoured plate can serve as an anatomic plate for efficient fracture reduction during pelvic surgery. This is the same concept as the indirect reduction technique for proximal humeral fracture fixation using anatomic locking plates [7]. These 3D printing techniques have been successfully used in orthopaedic surgeries [6,[8][9][10][11][12][13] and improved the surgeon's efficiency, shorten surgical duration, and reduce iatrogenic complications [14].…”