Proximal humerus fractures

Greiwe, R. Michael

doi:10.1016/b978-1-78242-449-9.00005-4

Cited by 3 publications

(3 citation statements)

References 122 publications

(130 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…É usada no tratamento de fraturas do olécrano, mandíbula, maléolo, sacro, tíbia e fêmur, entre outras. [5][6][7][8][9][10] Um estudo comparou parafusos esponjosos do tipo lag com rosca total ou parcial com base em cisalhamento, rigidez e carga de escoamento em blocos de osso artificial; ao aplicarem compressão axial nos parafusos, os autores descobriram que aqueles de rosca total eram biomecanicamente superiores em relação à rigidez inicial e carga de falha. 2 Outro estudo também teve como objetivo determinar diferenças entre parafusos esponjosos de tipo lag com rosca total ou parcial com base em sua estabilidade em um modelo suíno de escorregamento epifisário proximal do fêmur (EEPF).…”

Section: Introductionunclassified

“…It is used to help resolve olecranon, mandibular, malleolar, sacral, tibial, and femoral fractures, among others. [5][6][7][8][9][10] A study comparing fully-threaded cancellous lag screws to partially-threaded cancellous screws on the basis of shear, stiffness, and yield load by using saw-bone blocks to apply axial compression on the screws found that fully-threaded screws were biomechanically superior with regards to initial stiffness and failure load. 2 Another study also aimed to determine differences between fully-threaded and partiallythreaded cancellous screws based on their stability by using a porcine model that simulated slipped capital femoral epiphysis (SCFE).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Há diferença na força de compressão interfragmentar entre parafusos com rosca total ou parcial? Resultados de um estudo biomecânico experimental piloto

Okoro

Landgren

Afenu

et al. 2022

Rev Bras Ortop (Sao Paulo)

View full text Add to dashboard Cite

Resumo Objetivo Este estudo avaliou diferenças entre parafusos com rosca total ou parcial na resistência à compressão interfragmentar inicial. Nossa hipótese era de que haveria maior perda de resistência à compressão inicial com o parafuso de rosca parcial. Métodos Uma linha de fratura oblíqua de 45 graus foi criada em amostras de osso artificial. O primeiro grupo (TOTAL, n = 6) foi fixado com um parafuso de 3,5 mm de rosca total, enquanto o segundo grupo (PARCIAL, n = 6) usou um parafuso de 3,5 mm de rosca parcial. Avaliamos a rigidez à torção em ambas as direções de rotação. Os grupos foram comparados com base nos seguintes parâmetros biomecânicos: momento de rigidez-ângulo, momento de rigidez-tempo, momento de torção máxima (carga de falha) e força de compressão calibrada com base na medida do sensor de pressão. Resultados Depois da perda de uma amostra PARCIAL, não foram observadas diferenças estatisticamente significativas na força de compressão calibrada entre os 2 grupos [mediana (intervalo interquartil)]: TOTAL: 112,6 (10,5) N e PARCIAL: 106,9 (7,1) N, com p = 0,8 segundo o teste U de Mann-Whitney). Além disso, após a exclusão de 3 amostras para testes mecânicos (TOTAL, n = 5, PARCIAL, n = 4), não foram observadas diferenças estatisticamente significativas entre os construtos TOTAL e PARCIAL quanto ao momento de rigidez-ângulo, momento de rigidez-tempo ou momento de torção máxima (carga de falha). Conclusão Não há diferença aparente na força de compressão inicial (força de compressão ou rigidez do construto ou carga de falha) com o uso de parafusos de rosca total ou parcial neste modelo biomecânico em osso artificial de alta densidade. Parafusos de rosca total podem, portanto, ser mais úteis no tratamento de fraturas diafisárias. Mais pesquisas são necessárias sobre o impacto em modelos ósseos osteoporóticos ou metafisários de menor densidade e avaliação do significado clínico.

show abstract

Section: Introductionunclassified

Section: Introductionmentioning

confidence: 99%

Há diferença na força de compressão interfragmentar entre parafusos com rosca total ou parcial? Resultados de um estudo biomecânico experimental piloto

Okoro

Landgren

Afenu

et al. 2022

Rev Bras Ortop (Sao Paulo)

View full text Add to dashboard Cite

show abstract

“…8,16,17 Although there are not specific indications for when to obtain a computed tomography (CT) scan for proximal humeral fractures, they are frequently obtained as they can provide additional information about the nature of a fracture that cannot be obtained from plain films. 1,22 The purpose of this study was to use information available from the preoperative CT scan to create a simple and reproducible method to identify patients preoperatively who are at higher risk of screw cutout postoperatively.…”

mentioning

confidence: 99%

Preoperative measurement of the thickness of the center of the humeral head predicts screw cutout after locked plating of proximal humeral fractures

Stern¹,

Gorczyca

2021

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

Hypothesis and background: Preoperative computed tomography (CT) scans can be used to measure the thickness of the center of the humeral head to identify patients at a higher risk of screw cutout after open reduction-internal fixation. Methods: At an academic medical center, we performed a retrospective review of all patients aged ! 18 years who had sustained a proximal humeral fracture that was treated with open reduction-internal fixation between January 1, 2005, and December 31, 2014, and who underwent preoperative shoulder CT. Ninety-four patients were included. Patient charts were reviewed to obtain demographic data, and radiographs were reviewed to assess screw cutout. A standardized method was devised to measure the thickness of the center of the humeral head. Results: Screw cutout developed in 17 patients (17.7%). The mean humeral head thickness was significantly smaller on the axial (18 mm vs. 21 mm, P ¼ .0031), coronal (18 mm vs. 21 mm, P ¼ .0084), and sagittal (18 mm vs. 21 mm, P ¼ .0033) sections in the patients who experienced screw cutout. When the smallest of the 3 measurements for each patient was analyzed, the risk of cutout was markedly greater when the humeral head thickness was <20 mm (25% vs. 6%). In addition, when the humeral head thickness was >25 mm, the risk of cutout was reduced to 0%. A low-energy injury was associated with a lower risk of cutout whereas age, sex, and fracture classification were not independent predictors of cutout on multivariate logistic regression. Conclusions: In a patient with a proximal humeral fracture in whom a preoperative CT scan is available, calculating the thickness of the center of the humeral head may provide valuable information to both the surgeon and the patient for preoperative planning and counseling. A smaller thickness of the center of the humeral head on preoperative CT is predictive of screw cutout following locked plating of proximal humeral fractures. A measurement of >25 mm in any one plane is highly protective against cutout; however, extreme caution and consideration of supplemental fixation methods should be taken when the measurements in all planes are <15 mm. This information may be helpful in counseling patients regarding the possibility of postoperative screw cutout.

show abstract

Reconstruction of proximal humeral fractures with a reduced number of screws and a reinforced bone substitute

Cristofolini

Morellato

Cavallo

et al. 2020

Medical Engineering & Physics

View full text Add to dashboard Cite

Proximal humerus fractures

Cited by 3 publications

References 122 publications

Há diferença na força de compressão interfragmentar entre parafusos com rosca total ou parcial? Resultados de um estudo biomecânico experimental piloto

Há diferença na força de compressão interfragmentar entre parafusos com rosca total ou parcial? Resultados de um estudo biomecânico experimental piloto

Preoperative measurement of the thickness of the center of the humeral head predicts screw cutout after locked plating of proximal humeral fractures

Reconstruction of proximal humeral fractures with a reduced number of screws and a reinforced bone substitute

Contact Info

Product

Resources

About