Usually, these fractures can be advantageously treated by osteosynthesis quite often, the pathology is located on the medial metaphyseal side and the humeral head itself is not involved in the pathology. Four-part proximal humerus fractures: evaluation and treatment john r reineck, md, sumant g krishnan, md, after proximal humeral fracture, with ecchymosis osteosynthesis techniques when the humeral head is deemed viable and fracture ﬁxation is attempted, many methods of. Proximal humerus fractures – current treatment options zlomeniny proximálního humeru – současné možnosti léčby techniques such as pinning, screw osteosynthesis and intramedullary nails (27, 37, 43, 44, 48, 52, 55) howe- anatomy of the lateral proximal humeral metaphysis and. 621 humerus, proximal 1 assessment of fractures 573 11 imaging and classiﬁcation 573 many reduction and fixation techniques have been proposed fig 621-5 proposed algorithm for the surgical treatment of displaced proximal humerus fractures (a modification of hoffmeyer ) adequate blood supply good humeral head.
Proximal humeral fractures account for about 4 to 5% of all fractures 1,2,3,4,5,6 it accounts for up to 45% it accounts for up to 45% of all humeral fractures 7. Open reduction internal fixation four-part proximal humerus fractures multiple fixation methods have been described for osteosynthesis of proximal humerus fractures these methods include interfragmentary sutures or wires, tension plates have also been advocated in the treatment of true four-part fractures techniques have been. Minimally invasive osteosynthesis (mio) techniques is however considered more challenging and less forgiving for non diaphyseal fractures and requires continued strict adherence to previously well-established principles.
Orif technique for proximal humeral fracture is a traditional method by using deltopectoral approach to the proximal humerus it provides limited access to the posterolateral aspect of the shoulder, and the visualization and reduction of a large retracted greater tuberosity fragment may be difficult [ 15 , 16 . In nailing techniques, backing-out of the de llano-gimenez eq, fernandez-medina jm (2011) treatment proximal screws is a common problem related to osteo- of diaphyseal humeral fractures with the minimally invasive percutaneous plate (mippo) technique: a cadaveric study and porosis of the proximal humerus [41. Although most of the operative techniques for greater tuberosity fractures have predictable results, none has been established as the gold standard for the treatment of displaced greater tuberosity fractures 2,5,13,15-18 use of plate osteosynthesis for displaced proximal humerus fractures not isolated to the greater tuberosity is becoming more.
More precise reduction and high stability in open reduction and plate osteosynthesis of proximal humeral fractures have to be weighed against a greater risk of humeral head necrosis compared to. Ment of three-and four-part proximal humerus fractures p techniques potentially had a higher risk of disrupting this critical blood supply this was evident in the higher rates complications noted in their series included proximal screw loosening and extrusion in three patients and avascular ne. Treatment of proximal humeral fractures – minimal-invasive osteosynthesis, open reduction and plate fixation, intramedullary nailing and primary arthroplasty most proximal humeral fractures in the elder- port, humeral head ischemia and insufficient fracture reduction innovation of fixation techniques (e g angular stable loc. The anterolateral (acromial) approach (mackenzie) can be used for various treatments of proximal humeral fractures it is especially useful for nailing and osteosynthesis of fractures of the greater tuberosity (a1 fractures.
Minimally invasive plate osteosynthesis of the humeral shaft the application of minimally invasive surgical techniques with humeral shaft fractures although conservative management of humeral diaphyseal third fractures surgical approach the proximal access is the same as previ-ously described for distal access, when there is not enough. Despite the technological advances in fracture management, surgeons have yet to find the holy grail for the treatment of proximal humeral fractures treatment options currently considered include osteosynthesis utilizing plate and screw fixation, k-wire fixation, intramedullary rodding, and hemiarthroplasty. Minimally invasive plate osteosynthesis (mipo) has been used for humeral shaft fractures, but concerns exist about soft tissue injuries the purpose of this study was to report the surgical. Background and purpose — it is unclear whether previous osteosynthesis is a risk factor for inferior outcome following shoulder arthroplasty for a proximal humeral fracture we used data from the danish shoulder arthroplasty registry (dsr) to examine this question patients and methods — all 285. Proximal humeral fractures are witnessed mainly in the elderly population, with the highest prevalence being 405 per 100,000 in those patients aged over 70 years [1-3.
Stryker osteosynthesis devices and instruments it offers guidance that you should heed, but, as with any such technical types of proximal and/or diaphy-seal fractures of the humerus • the t2 proximal humeral nail the t2 proximal humeral nail is designed to be inserted either through a lateral (a) or a central (b) entry. Different methods have been used in the treatment of proximal humeral fractures usually, treatment choice depends on fracture displacement, patient age, osteoporosis, and other characteristics locking plate fixation has become the most widely used method among surgical techniques, while partial arthroplasty is reserved for older patients and. The osteosynthesis of fractures of the proximal humerus with fixed-angle plates and locking philos screws proved to be a technique with satisfactory functional results and a low complication rate in this group of patients.
Proximal humeral fracture dislocations, and 4-part valgus impacted fractures however, nail fixation for ph frac- proximal humerus nailing is an osteosynthesis tech-nique we have been using since 2000 with the telegraph nail (fh orthopedics, heimsbrunn, france) 94 techniques in shoulder & elbow surgery godene`che et al. The treatment of third proximal humerus complex fractures represents a challenge and osteosynthesis techniques are still controversial the authors report a new device that has been planned and used to treat this type of fracture, suitable for both young and elderly patients the device consists of. It is a common injury, representing 3% to 5% of all fractures in adults 8% of humeral shaft fractures are pathological it also represents 3% of all fractures in children and constitutes less than 10% of humeral fractures in children.
In most proximal humeral fractures, the medial calcar of the proximal humerus is intact (this calcar is the proximal medial humeral shaft just inferior to the anatomic neck) (fig 8) in the few cases where the medial calcar is fractured, this fragment is often large and can be rigidly fixed with simple wire or heavy suture fixation. The optimal surgical management of dislocated three- and four-part fractures of the proximal humerus in elderly patients remains unclear most used techniques are hemiarthroplasty and angle-stable locking compression plate osteosynthesis in the current literature there is no evidence available presenting superior results between hemiarthroplasty and angle-stable locking compression plate. Retainer for osteosynthesis of fractures the proximal part of the humerus 5 the utility model relates to medicine, and more particularly to traumatology and orthopedics, and can be applied in the surgical treatment of fractures of the proximal humerus metaepiphysis (head, anatomic and surgical neck. 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.