Plate fixation of proximal humeral fractures

Abstract

We performed open reduction and internal fixation with a T-buttress plate in 32 fractures of the proximal humerus with severe displacement and/or fracture dislocation. In 27 cases acceptable reduction was achieved. In four cases infection developed, and the implant was removed in five cases because of impingement of the plate under the acromion and in two cases because of loosening. There was no nonunion, but four humeral head necroses. At the re examination of 20 patients after 2-7 years, nine were excellent or satisfactory and eleven unsatisfactory or poor. We conclude that the buttress plate offers satisfactory reduction and good stability at a high risk for complications. The indications for this method should be carefully considered, notably in the elderly, and the operation should only be performed by experienced orthopedic surgeons.

Estudo comparativo entre a porca convencional e a porca para fixação óssea (PFO): avaliação em laboratório

“…Tomamos como exemplo desta situação a região metafisária do terço proximal do úmero, cujas fraturas, principalmente em idosos, muitas vezes não podem ser estabilizadas com material de osteossíntese interna convencional (placas e parafusos), pois os parafusos simplesmente não "dão pega" (18) .…”

“…Relatos recentes de vários autores demonstram os maus resultados obtidos nas osteossínteses com placas nas fraturas em três e quatro partes do terço proximal do úmero, sendo a perda da fixação da placa, com afrouxamento dos parafusos, uma das complicações (18)(19) .…”

Functional Outcome of Philos Plate Fixation for Proximal Humerus Fractures

“…They include K wire fixation, suture fixation, external fixation, tension band fixation, intramedullary nails and plating. 4,5 The complication rate for different modalities is as high as 50% or even higher. 8,9 Various complications that has been reported are cut-out or back out of the screws and plates, non-union, avascular necrosis, nail migration, rotator cuff impairment and impingement syndrome.…”

“…3 Various treatment modalities are available for the treatment of these fractures, they include K wire fixation, suture fixation, external fixation, tension band fixation, intramedullary nails and plating. 4,5 Philos plate has been developed to improve screw fixation in osteoporotic bone and to minimise soft tissue dissection. 6 This is a precontoured locking compression plate for the proximal humerus.…”

Resultados do tratamento das fraturas do terço proximal do úmero com placas de bloqueio

“…In fractures with deviations and unstable fractures, surgical treatment is indicated. There are different fracture fixation methods such as the use of plates and screws, [4][5][6][7] percutaneous fixation with metallic wires, 8 tension band, 9 external fixation, 10 fixed-angle plates, 11 proximal locking plates 12 and arthroplasty. 13,14 All the fixation methods have their advantages and disadvantages.…”