Treatment for proximal humeral fractures with percutaneous plating: our first results

Imarisio, Daniele; Trecci, Andrea; Sabatini, Luigi; Scagnelli, Roberto

doi:10.1007/s12306-013-0266-z

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…Procedures using closed reduction are of course less invasive, but it is more difficult to achieve good reconstruction. On the other side, open techniques are more likely to obtain anatomical reduction and stronger fixation, but they present a higher rate of complications related to complete or partial necrosis of the humeral head, regardless of the implant used [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although proximal humeral fractures are common lesions of the elderly, accounting for 5% of all fractures and 45% of all humeral fractures [ 1 - 3 ], there is no consensus regarding their treatment. The majority of patients suffering this injury have nondisplaced or minimally displaced two- or three-part fractures.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, many surgical solutions such as operative fixations (retrograde percutaneous pin fixation [ 5 ], transcutaneous fixation with Kirschner wires [ 8 ], and tension band osteosynthesis [ 9 ]) and hemiarthroplasty [ 10 ] are applied to treat these lesions, ranging from percutaneous pinning to shoulder arthroplasty [ 1 ]. These surgical solutions have added to the surgeon's armamentarium of methods to treat proximal humeral fractures and have been suitable for patients with various conditions.…”

Section: Introductionmentioning

confidence: 99%

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Avascular necrosis in proximal humeral fractures in patients treated with operative fixation: a meta-analysis

Zhang

Wang

2014

J Orthop Surg Res

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BackgroundProximal humeral fractures are common lesions of the elderly, but there are no established treatment guidelines. A surgical treatment for comminuted and displaced fractures of the proximal humerus was developed and is still evolving. The aim of this study was to perform a quantitative review to evaluate the risk of avascular necrosis (AVN) in patients with proximal humeral fractures who were treated by operative fixation compared with conservative treatment.MethodsWe searched the PubMed, MEDLINE, Springer, Elsevier Science Direct, Cochrane Library, Google Scholar, China National Knowledge Infrastructure (in Chinese), and Wanfang database (in Chinese) up to December 2013 to identify studies related to operative fixation and AVN in patients with proximal humeral fractures.ResultsSeven studies with a total of 291 patients (142 operative fixation cases and 149 conservative treatment cases) with proximal humeral fractures were considered in the meta-analysis. The overall meta-analysis showed no significant difference in the incidence of AVN between the two groups [odds ratio (OR) 1.42, 95% confidence interval (CI) 0.33–6.11, p = 0.64]. The subgroup meta-analysis by study design (retrospective/prospective), sample size (≤40/>40), and ethnicity (European/Asian) demonstrated similar results. However, the subgroup analysis by specific operative approach (plate fixation/tension band wiring fixation/others) indicated that plate fixation was associated with a higher rate of AVN than conservative treatment (OR 0.20, 95% CI 0.05–0.76, p = 0.019).ConclusionsPlate fixation was associated with a higher risk of AVN development than conservative treatment in patients with proximal humeral fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Avascular necrosis in proximal humeral fractures in patients treated with operative fixation: a meta-analysis

Zhang

Wang

2014

J Orthop Surg Res

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“… 10 However, some authors have already demonstrated safety of the anterolateral approach as well as the low chance of axillary nerve injury. 10 – 12 Moreover, this approach facilitates exposure of the lateral humeral surface and identification of major tuberosity fractures that are subsequently dislocated. 10 …”

Section: Discussionmentioning

confidence: 99%

Does Surgeon Specialization Change the Proximal Humeral Osteo-Synthesis Approach?

et al. 2019

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Objective: To evaluate the choice of surgical approach among Brazilian orthopedists and whether shoulder surgery specialty training or duration of experience influences the decision-making. Methods: A questionnaire on the preferred approach and complications was administered to orthopedic surgeons with and without shoulder specialization training. The chi-square test or Fisher's exact test was applied. Results: We interviewed 114 orthopedists, 49 (43.0%) traumatologists, 36 (31.5%) specialist surgeons, and 29 (25%) shoulder surgery specialist residents. In cases of fracture without dislocation, specialized training and duration of experience did not influence the approach used (primarily deltopectoral). In cases of fracture/dislocation, 97.2% of the specialists versus 82.1% of the traumatologists opted for the deltopectoral approach (p = 0.034). In cases of fractures/dislocation, 92.5% of surgeons with more than 5 years of experience and 78.7% with less than 5 years of experience opted for the deltopectoral approach (p = 0.032). Conclusion: Specialization in shoulder surgery did not influence surgeons' approaches to manage fractures without dislocation. In cases of fracture/dislocation, shoulder surgery specialization training and duration of experience were associated with selection of the deltopectoral approach. Level of Evidence V, Expert opinion.

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“…Biomechanisch werden deutliche theoretische Vorteile beschrieben, welche jedoch in prospektiv randomisierten Studien klinisch nicht reproduzierbar waren[9]. In einer retrospektiven Studie mit einer kleinen Patientenzahl werden ein gutes Ergebnis, keine Schraubendislokation, keine Humeruskopfnekrose, regelrechte Konsolidierung und ein geringer Weichteilschaden beschrieben[11].…”

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Proximale Humerusfrakturen

Müller¹,

Grützner²,

Studier-Fischer³

2020

Orthopädie und Unfallchirurgie up2date

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Treatment for proximal humeral fractures with percutaneous plating: our first results

Abstract: Percutaneous plating of proximal humeral fractures with NCB-PH plate has demonstrated to be a good strategy in managing these lesions without increasing complications.

Cited by 7 publications

References 14 publications

Avascular necrosis in proximal humeral fractures in patients treated with operative fixation: a meta-analysis

Avascular necrosis in proximal humeral fractures in patients treated with operative fixation: a meta-analysis

Does Surgeon Specialization Change the Proximal Humeral Osteo-Synthesis Approach?

Proximale Humerusfrakturen

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