Open Reduction and Internalfixation of Three and Four-Part Fractures of the Proximalpart of the Humerus

Wijgman, A J; Roolker, W.; Patt, Thomas W; Raaymakers, E. L. F. B.; Marti, R K

doi:10.2106/00004623-200211000-00002

Cited by 314 publications

(220 citation statements)

References 11 publications

Supporting

Mentioning

178

Contrasting

Unclassified

Order By: Relevance

“…13,14 However the locking plate fixation type of fixation requires more surgical proficiency and care especially regarding the preservation of the soft tissue structures and blood supply and vascularity of the fractured segments during this open reduction and internal fixation technique. 15,16,17 In our study we utilized the deltopectoral approach in the patients of the proximal humerus fractures, the important points that must be taken care of are the placement of the plate of proper length, using the fluoroscopic imaging when placing the screws in the correct position and avoiding the varus displacement by ensuring support to the medial side of the cortex. 18,19,20 The overall complication rate in our study was found to be 18% and 10% of the patients had varus malunion, while the remainder of the complications were impingement, infection, failure of fixation and intra articular screw, revision surgeries were performed for the patients with deep infection and failure of fixation.…”

Section: Discussionmentioning

confidence: 99%

Proximal Humerus Fractures; Radiological and Functional Outcome as Treated With the Philos Plating System, at a Tertiary Care Centre in Karachi, Pakistan.

Jabbar¹

2017

TPMJ

View full text Add to dashboard Cite

ABSTRACT… Objectives:The aim of our study is to study the radiological and functional outcome of proximal humerus fractures treated via open reduction and internal fixation using the proximal humerus internal locking system or PHILOS. Study Design: Case series study. Period 05 years duration from January 2011 to December 2015. Setting: Large tertiary care centre in Karachi, Pakistan. Materials and methods: The study population consisted of n=50 patients all of whom underwent open reduction and internal fixation utilizing the proximal humeral internal locking system or PHILOS for fractures of the proximal humerus. The inclusion criterion was all the patients with closed fractures of the proximal humerus and were belonging to 2,3 and 4 part of the Neer system of classification. Physiotherapy was started as soon as possible for the patients. Serial radiographic imaging in two views was done at 6, 12, 24 and 52 weeks postoperatively. For the functional outcome of the procedure Constant and Murley scoring system was used. Data was analyzed using IBM SPSS version 21. Results: The study population consisted of n= 50 patients of which n= 35 were males and n= 15 were females having a mean age of 38.50 years. The mean duration of follow up was 24 months. All the patients in the study had union of fracture both radiographically and clinically, the mean time duration for the radiographically evident union of the humerus bone was 12 weeks with a range of 8 to 20 weeks, the mean Constant Murley score for the functional outcome of the shoulder joint was 79 at the final follow up with a range of 50 to 100. Complications were found in n= 9 patients and varus malunion was the most common complication. In our case series we did not observe complications such as avascular necrosis, non union or implant failure. Conclusion: According to the results of our study the proximal humerus internal locking system or PHILOS is a good method for open reduction and internal fixation of the proximal humerus fractures and provides a stable fixation, and has lower incidence of complications such as avascular necrosis. Key words:Humerus fractures; Open reduction internal fixation; Proximal humerus internal locking system; PHILOS; Surgical outcome. Article Citation: Jabbar FA, Shah RA. Proximal humerus fractures; radiological and functional outcome as treated with the philos plating system, at a tertiary

show abstract

Section: Discussionmentioning

confidence: 99%

Proximal Humerus Fractures; Radiological and Functional Outcome as Treated With the Philos Plating System, at a Tertiary Care Centre in Karachi, Pakistan.

Jabbar¹

2017

TPMJ

View full text Add to dashboard Cite

show abstract

“…Nos dois casos citados, a única lesão foi a fratura do tubérculo maior. Há outros seis casos descritos na literatura de fratura luxação intratorácica em que o fragmento da cabeça do úmero não estava preso à diáfise, sendo o mais recente o de um paciente de 27 anos de idade, o mais jovem já descrito (2)(3)(7)(8)(9)(10) . Wirth et al relataram um caso de fratura da extremidade proximal do úmero com luxação retroperitoneal em uma paciente de 28 anos, tendo o fragmento da cabeça do úmero sido recuperado e fixado com dois parafusos; o seguimento após seis anos mostrou que houve necrose da cabeça do úmero, com evolução para acentuada deformidade, conseqüente artrose glenoumeral e redução da função do ombro (6) .…”

Section: Discussionunclassified

“…O suprimento arterial primário da extremidade proximal do úmero é feito por um ramo da artéria circunflexa umeral anterior e a contribuição vascular de menor valor surge da artéria circunflexa umeral posterior e vasos, que entram através das aderências dos tecidos moles do manguito rotador (9) . Tem sido proposto que, durante a redução aberta e fixação interna, a proteção dos tecidos moles e suas aderências pode preservar algum fluxo para a cabeça do úmero (10) .…”

Section: Discussionunclassified

Fratura epifisiolise da extremidade proximal do úmero com luxação intratorácica: relato de caso

2008

View full text Add to dashboard Cite

cularização durante seis anos, em paciente adolescente, parece não terem sido previamente relatados. Descritores Keywords -Epiphysiolysis; Aseptic necrosis of the bone;Case report INTRODUÇÃO A fratura luxação intratorácica da extremidade proximal do úmero é extremamente rara (1) . Essa lesão tem sido relatada em pacientes idosos, após queda com a RESUMO A fratura da extremidade proximal do úmero com luxação intratorácica foi relatada em 1949 por West, em que a fratura era, somente, do tubérculo maior. Desde então, poucos casos foram relatados na literatura, a maioria constituída por pessoas idosas, prevalecendo como indicação terapêutica artroplastia parcial. Os autores relatam o caso de um adolescente de 14 anos de idade, sexo masculino, que apresentou fratura epifisiolise da extremidade proximal do úmero com luxação intratorácica em decorrência de acidente ciclístico e que foi submetido a tratamento cirúrgico com redução, osteossíntese e reinserção do manguito rotador. A recuperação da cabeça do úmero totalmente desvitalizada e o acompanhamento do processo de necrose e revas-

show abstract

“…3,4 With the advent of locking plate technology and the development of proximal humerus locking plates, open reduction and internal fixation (ORIF), for the treatment of displaced and unstable proximal humerus fractures, has garnered a great deal of recent clinical attention. [5][6][7][8] Treatment of complex fracture patterns, especially in the elderly individuals, continues to be a challenging and controversial clinical scenario, and there still remains no consensus for the optimal treatment algorithm for these types of fractures. 9 More current data, concerning the use of locking plates in the treatment of proximal humerus fractures, has been very encouraging.…”

Section: Introductionmentioning

confidence: 99%

Open Reduction and Internal Fixation (ORIF) of Complex 3- and 4-Part Fractures of the Proximal Humerus

Grawe

Lee

et al. 2011

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

Introduction: Treatment of complex fracture patterns of the proximal humerus continues to be a challenging and controversial clinical scenario. The aim of this study was to report on the outcomes of complex displaced 3-and 4-part fractures of the proximal humerus treated with locked plating and compare the functional results of patients on the basis of age at time of injury. Methods: A retrospective review was completed to identify patients whom had sustained a 3-or 4-part fracture of the proximal humerus (Neer classification), treated surgically with locked compression plating. Patients were recruited for a final follow-up, with clinical (Constant and Disabilities of the Arm, Shoulder, Hand [DASH] scores) and radiographic outcome analysis. Results were compared (t test and Wilcoxon test) with fracture type (3-vs 4-part) and patient age at time of fracture (<65 years vs >65years) as the primary outcome measure. The presence or absence of a complication and presence or absence of a concomitant osseous injury at the time of presentation were evaluated as secondary outcome measures, in regard to overall functional results of the treatment in question. Complications were defined as posttraumatic osteoarthritis, avascular necrosis of the humeral head, and screw cutout with chondrolysis. The null hypothesis being that age of the patient at the time of injury would not greatly affect functional outcome measurements. Results: Forty-five fractures were identified in 45 patients, with 31 three-part fractures and 14 four-part fractures, and 17 patients were available for final follow-up (9 three-part and 8 four-part). Twelve patients were identified as under the age of 65 years and were compared with 5 patients who were identified as older than 65 years of age. The relative Constant score, at final follow-up, for those under the age of 65 was 88.58, while the score for those above the age of 65 was 82.5. In a similar fashion, the DASH score for those younger than 65 was 11.67, while the score for those older than 65 was 12.5. Neither the Constant score nor the DASH score differed in a statistically significant manner, when comparing patients who were younger than 65 to those older than 65 years of age. Conclusion: The current series of fractures was able to demonstrate similar and satisfactory outcomes following locked plating treatment of complex 3-and 4-part proximal humerus fractures in younger patients and patients older than the age of 65, while still accepting the null hypothesis.

show abstract

Open Reduction and Internalfixation of Three and Four-Part Fractures of the Proximalpart of the Humerus

Cited by 314 publications

References 11 publications

Proximal Humerus Fractures; Radiological and Functional Outcome as Treated With the Philos Plating System, at a Tertiary Care Centre in Karachi, Pakistan.

Proximal Humerus Fractures; Radiological and Functional Outcome as Treated With the Philos Plating System, at a Tertiary Care Centre in Karachi, Pakistan.

Fratura epifisiolise da extremidade proximal do úmero com luxação intratorácica: relato de caso

Open Reduction and Internal Fixation (ORIF) of Complex 3- and 4-Part Fractures of the Proximal Humerus

Contact Info

Product

Resources

About