The clinical benefit of medial support screws in locking plating of proximal humerus fractures: a prospective randomized study

Zhang, Lei; Zheng, Jiayong; Wang, Weiliang; Guo, Lin; Huang, Yijiang; Zheng, Jin; Prince, Ghamor-Amegavi Edem; Gao, Yang

doi:10.1007/s00264-011-1227-5

Cited by 113 publications

(102 citation statements)

References 21 publications

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“…There was a significant loss of humeral height indicating varus collapse in patients without medial support compared with patients with the medial support. Zhang et al 23) also reported that patients without medial support screw exhibited a significantly higher failure rate and loss of neck-shaft angle loss at final follow-up, as well as better functional outcomes compared with patients with medial support screw.…”

Section: Discussionmentioning

confidence: 97%

“…Our study used a similar indication for using the strut bone as other previous studies. 14,23) Our study has several limitations. First, our study was a retrospective case-series that did not have a control group to use as a comparison.…”

Section: Discussionmentioning

confidence: 99%

“…Although we were unable to compare the postoperative value with the preoperative value in this study, as we evaluated the functional scores only after surgery, the postoperative functional scores in this study was comparable to them in other previous studies. [15][16][17]22,23) In surgical intervention for the unstable proximal humerus fractures with osteoporosis, the anatomical reduction at the medial calcar has been emphasized; 7,11,12) in particular, if metaphyseal comminution is combined, and therefore anatomical reduction and its maintenance were not feasible, other options, such as inferomedial calcar screw or intramedullary strut bone graft, should be considered. Gardner et al 7) emphasized the importance of medial support (either by anatomical reduction of medial cortex or oblique locking screw placement for medial calcar support) in locking the plate fixation of proximal humerus fractures.…”

Section: Discussionmentioning

confidence: 99%

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Operative Treatment with Intramedullary Fibular Strut Allograft for Osteoporotic Proximal Humerus Fracture

Chun

Lee

2017

Clinics in Shoulder and Elbow

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Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in 20° external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in 20° external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was 138° ± 4°, and at one-year follow-up, the neck shaft angle was 137° ± 5°. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Operative Treatment with Intramedullary Fibular Strut Allograft for Osteoporotic Proximal Humerus Fracture

Chun

Lee

2017

Clinics in Shoulder and Elbow

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“…Proximal humeral fractures in varus deviation frequently jeopardize the calcar area [41,42]. A well-positioned strut screw is essential to support the load and compress the fracture, thereby improving fixation stability [43].…”

Section: Discussionmentioning

confidence: 99%

Proximal humeral fractures: an understanding of the ideal plate positioning

Labronici

Albuquerque

Schott

et al. 2014

International Orthopaedics (SICOT)

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“…3), denn initial ischämische Kalotten können nach korrekter Reposition und stabiler Fixation revaskularisieren [3]. In verschiedenen Studien konnte belegt werden, dass eine anatomische Reposition zu besseren Ergebnissen und weniger Komplikationen führt [36,69].…”

Section: Introductionunclassified