scholarly journals Minimally Invasive Plate Osteosynthesis for Proximal Humerus Fractures: A Retrospective Study Describing Principles and Advantages of the Technique

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Riccardo Luigi Alberio ◽  
Matteo Del Re ◽  
Federico Alberto Grassi
Keyword(s):  
Minimally Invasive ◽  
Proximal Humerus ◽  
Plate Osteosynthesis ◽  
Humeral Fractures ◽  
Radiographic Evaluation ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Proximal Humerus Fractures ◽  
Greater Tuberosity ◽  
Humerus Fractures ◽  
The Mean

Background. The aim of this study was to evaluate the clinical and radiographic results after minimally invasive plate osteosynthesis (MIPO) for proximal humerus fractures. Potential advantages of this approach include the easier exposure of the greater tuberosity and the limited surgical dissection around the fracture site. Materials and Methods. From October 2011 to March 2016, thirty-nine patients (32 women, 7 men) with a mean age of 64.9 years (range: 48–80) were surgically treated with the MIPO technique for proximal humeral fractures. According to Neer classification, there were 12 two-part, 24 three-part, and 2 four-part fractures and 1 two-part fracture-dislocation; the AO/OTA system was also used to categorize the fractures. The Constant-Murley (CMS) and the Oxford Shoulder (OSS) Scores were used to evaluate shoulder function. Results. Thirty-four patients were available for clinical and radiographic evaluation at a mean follow-up of 31.8 months (range: 12–54 months). All fractures healed and no postoperative complications occurred. Full recovery of pretrauma activities was reported by 27 patients, while 7 patients presented mild functional limitations. The mean absolute CMS was 75.2 (range: 55–95), the mean normalized CMS was 90.5 (range: 69–107), and the mean OSS was 43.7 (range: 31–48). The only statistically significant correlation was found between the female gender and lower absolute CMS and OSS. Radiographic evaluation revealed varus malunion in 4 cases and valgus malunion in 1 case, while incomplete greater tuberosity reduction was detected in 4 cases. All malunions were related to inadequate reduction at time of surgery and not to secondary displacement. Conclusions. MIPO for proximal humeral fractures is an effective and safe surgical procedure. The limited tissue dissection allows minimizing the incidence of nonunion, avascular necrosis, and infection. The technique is not easy, requires experience to achieve mastery, and should be reserved for selected fracture patterns. In our experience, the main advantage of this approach consists in the direct access to the greater tuberosity, thus facilitating its anatomic reduction and fixation.

scholarly journals Minimally invasive percutaneous plate osteosynthesis for the treatment of proximal humerus fractures in osteoporotic patients with Philos plate

2013 ◽  
Vol 12 (2) ◽  
pp. 140-145
Author(s):  
Ram Ji Lal Sahu
Keyword(s):  
Minimally Invasive ◽  
Proximal Humerus ◽  
Plate Osteosynthesis ◽  
Medical Science ◽  
Functional Results ◽  
Autogenous Bone ◽  
Proximal Humerus Fractures ◽  
Philos Plate ◽  
Humerus Fractures ◽  
A Prospective Study

Introduction: To investigate the effect of minimally invasive percutaneous plate osteosynthesis for treatment of proximal humerus fractures in osteoporotic patients with philos plate. Methods: A prospective study was conducted at Department of Orthopedics, M.M.Medical College, Mullana Ambala, from July 2005 to November 2010. A Total of 108 cases of proximal humerus fractures were treated with minimally invasive percutaneous plate osteosynthesis with philos plate. According to Neer classification, 89 cases had two part fractures, 19 had tree part fractures. Results: All the 108 cases were followed up ranging from 12 to 18 months with an average of 14 months. Radio graphically, union was observed in 92 patients at the end of 10 weeks. In 10 patients, times to union were 16 weeks. Six patients underwent autogenous bone grafting because of nonunion after 16 weeks. The mean Constant-Murley score was 86 (range 74-92). The functional results of the shoulder, according to Muley scores, were classified as excellent in 85.15% cases, good in 9.25% cases and fair in 5.55 cases. Conclusion: Minimally invasive percutaneous plate osteosynthesis for treatment of proximal humerus fractures in osteoporotic patients with philos plate shows good results and less complication. Bangladesh Journal of Medical Science Vol. 12 No. 02 April’13 Page 140-145 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14941

scholarly journals A novel surgical approach and technique and short-term clinical efficacy for the treatment of proximal humerus fractures with the combined use of medial anatomical locking plate fixation and minimally invasive lateral locking plate fixation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fu Wang ◽  
Yan Wang ◽  
Jinye Dong ◽  
Yu He ◽  
Lianxin Li ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Shoulder Joint ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Anterolateral Approach ◽  
Proximal Humerus Fractures ◽  
Locking Plate Fixation ◽  
Humerus Fractures

Abstract Background and hypothesis The typical anterolateral approach is widely used to treat proximal humerus fractures with lateral locking fixation. However, lateral fixation cannot completely avoid medial reduction loss and varus deformity especially in the cases of an unstable medial column. We present a novel medial surgical approach and technique together with a minimally invasive lateral locking plate to fix proximal humerus fractures with an unstable medial column. Materials and methods We performed an anatomical study and reported 8 cases of proximal humerus fractures with unstable medial columns treated with plate fixation through a minimally invasive anterolateral approach and medial approach. All surgeries were performed by the same single surgeon. Patients were followed clinically and radiographically at 1, 3, 6, and 12 months postoperatively. Results There was a safe region located at the medial part of the proximal humerus just beneath the articular surface. An anatomical medial locking proximal humerus plate could be placed in the medial column and did not affect the axillary nerve, blood supply of the humeral head, or stability of the shoulder joint. Successful fracture healing was achieved in all 8 cases. The function and range of motion of the shoulder joint were satisfactory 24 months postoperatively, with an average Constant score (CS) of 82.8. No reduction loss (≥ 10° in any direction), screw cutout, nonunion, or deep infection occurred. Conclusions The combined application of medial anatomical locking plate fixation and minimally invasive lateral locking plate fixation is effective in maintaining operative reduction and preventing varus collapse and implant failure in proximal humerus fractures with an unstable medial column.

scholarly journals Effect of Osteoporosis on Proximal Humerus Fractures

2020 ◽  
Vol 11 ◽  
pp. 215145932098539
Author(s):  
Anil Taskesen ◽  
Ali Göçer ◽  
Kadir Uzel ◽  
Yüksel Uğur Yaradılmış
Keyword(s):  
Surgical Outcomes ◽  
Proximal Humerus ◽  
City Hospital ◽  
Proximal Humerus Fractures ◽  
Fracture Type ◽  
Age And Gender ◽  
Humerus Fractures ◽  
The Mean ◽  
And Gender ◽  
Fracture Types

Introduction: Proximal humerus fractures (PHF) constitute the majority of the most common osteoporotic fractures. Bone density measurements can affect treatment methods and outcomes. This study was aimed to investigate the effect of osteoporosis values, measured from direct radiographs, on fracture type, surgical outcomes. Methods: 248 patients over 50 years of age who presented to Mersin City Hospital between 2017 and 2020 with proximal humeral fractures were retrospectively evaluated. The age and gender of the patients and the fracture types were evaluated according to the AO classification system from the direct radiographs obtained at the time of admission were recorded. The Tingart cortical thickness and deltoid tuberosity index (DTI) measurements were used to assess osteoporosis status in all patients. Postoperative and follow-up radiographs of 45 patients, treated with fixed-angle proximal humeral locking plate, were evaluated for radiographic results and their correlations with osteoporosis measurements were examined. Results: According to the demographic characteristics of the patients, 171 patients were female and 77 patients were male (F/M: 3/1), and mean age was 69.2 ± 11.66 (50-95). Considering the bone quality parameters in all patients, the mean Tingart value was 5.8 ± 1.6 mm and the mean DTI was 1.43 ± 0.17, where there was a correlation between the Tingart value and DTI (r = 0.810 and p < 0.001). Although there was a statistically significant relationship between the osteoporosis parameters and age and gender (p < 0.001 and p = 0.023, respectively), main AO fracture types were not related to osteoporosis (p < 0.05). In the operated group (n = 48, 19%), 19 patients (42%) showed poor outcomes, which were not associated with age and osteoporosis parameters. Conclusion: This study was concluded that osteoporosis parameters differ between genders and age groups in patients with PHF, however osteoporosis is not the main factor affecting the fracture type and surgical outcomes.

scholarly journals Minimally invasive fixation with modified palm tree technique for proximal humerus fractures: Outcomes in a series of 132 patients

2021 ◽  
Vol 17 ◽  
pp. 11-17
Author(s):  
Andreas Leonidou ◽  
Siddharth Virani ◽  
Georgios Panagopoulos ◽  
Giuseppe Sforza ◽  
Ehud Atoun ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Proximal Humerus ◽  
Palm Tree ◽  
Proximal Humerus Fractures ◽  
Humerus Fractures ◽  
Minimally Invasive Fixation

scholarly journals FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING COMPRESSION PLATE: A CROSS SECTIONAL STUDY

2021 ◽  
Vol 10 (4) ◽  
pp. 3266-3269
Author(s):  
Abhishek Patil
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Humerus Fractures ◽  
The Mean

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.

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