The surgical treatmant of the proximal humerus fractures with Humerusblok in elderly
Authors:
Filip Burget; Karel Kudrna
Authors‘ workplace:
I. chirurgická klinika 1. LFUK a VFN v Praze
Published in:
Úraz chir. 20., 2012, č.4
Overview
INTRODUCTION:
The surgical treatment of three and fourpart fractures of the proximal humerus in osteoporotic bone is difficult and there is no consensus as to which technique leads to the best outcome in elderly patients. The objective of this work is to present results of the prospective study of patients treated with Humerus block.
METHODS:
In a prospective study were monitored patients over the age of 60 with proximal humerus fracture type 11 A2- 11C2 AO classification treated with Humerus block at the 1st Surgical clinic of Medical Faculty of the Charles University in Prague in period from 1st April 2010 to 31st March2012. The postoperative results were assessed by the Constant score at 3, 6 and 12 months follow-up.
RESULTS:
Between 1st April 2010 and 31st March 2012 we treated 80 patients older 60 years with proximal humerus fracture, 56 underwent the surgery. Of the 26 patients we treated with Humerus block, only 23 were available for follow-up. The mean Constant score for two-part fracture was 62,3 points (37-90 points), in three-part fractures 53,6 points (31-80 points) and four-part fractures 40 points (16-76 points). In two cases there was a failure of the method due to protrusion of K wires, once we observed prolonged healing, but there was no avascular necrosis of the humeral head, pseudoarthrosis, deep infect nor axillary nerve damage in our study group.
CONCLUSION:
The Humerus block technique due to its miniinvasive approach, sufficient stability, good pain relief and relatively inexpensive implant device is a satisfactory alternative to replacement and traditional techniques of internal fixation.
KEY WORDS:
proximal humerus fracture, Humerus block.
Sources
1. BOGNER, R., HÜBNER,C., MATIS, N. Minimally-invasive treatment of three- and four- part fractures of the proximal humerus in elderly patients. J Bone Joint Surg Br. 2008, 90, 1602-1607.
2. CONSTANT, C., MURLEY, A. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987, 214, 160-164.
3. COURT-BROWN, C.M., GARG, A. MCQUEEN, M.M. The epidemiology of proximal humeral fractures. Acta Orthop Scand. 2001, 72, 365-371.
4. DUDA, G.N., EPARI, D.R., BABST, R., LAMBERT, S. Mechanical evaluation of a new minimally invasive device for stabilization of proximal humeral fractures. Acta Orthop Scand. 2001, 78, 430-435.
5. KARTAGLIS, D., STAVRIDIS, S.I., PETSATODIS, G. New trends in fixation of proximal humeral fractures: A rewiew. Injury. 2011, 42, 330-338.
6. KRALINGER, F, GSCHWENTNER, M., WAMBACHER, M. Proximal humeral fractures: what is semi-rigid? Biomechanical properties of semi-rigid implants, a biomechanical cadaver based evaluation. Arch Orthop Trauma Surg. 2008, 128, 205-210.
7. KŘIVOHLÁVEK, M., LUKÁŠ, R., TALLER, S. Použití úhlově stabilních implantátů při ošetření zlomenin proximálního humeru-prospektivní studie. Acta Chir orthop Traum čech. 2008, 75, 212-220.
8. LANTING, B., MACDERMID, J., DROSDOWECH, D. Proximal humeral fractures:a systematic review of treatment modalities, J shoulder Elbow Surg. 2008,17, 42-45.
9. LILL, H., HEPP, P., KORNER, J., ET AL. Proximal humeral fractures: how stiff should an implant be? A comparative mechanical study with new implants in human specmens. Arch Orthop Trauma Surg. 2003, 123, 74-81.
10. MOONOT, P., ASHWOOD, N., HAMLET, M. Early results for treatment of three- and four- part fractures of proximal humerus using PHILOS plate systém. J Bone Joint Surg Br. 2007, 89, 1206-1209.
11. RESCH, H., POVACZ, P., FRÖHLICH, R. Percutaneous fixation of three- and four- part fractures of the proximal humerus, J Bone Jonint Surg Br. 1997, 79, 295-300.
12. VUNDELINCKX, B.J., DIERICKX, C.A., BRUCKERS, L. Functional and radiographic medium-term outcome evaluation of the Humerus Block, a minimally ivasive operative technique for proximal humeral fractures. J Shoulder Elbow Surg. 2011, 1-10.
Labels
Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2012 Issue 4
Most read in this issue
- The treatment of unstable fractures of fifth metacarpal bone by external fixator
- Surgical Treatment of Distal Crural Fractures
- The surgical treatmant of the proximal humerus fractures with Humerusblok in elderly
- Two-stage operative treatment of complicated distal tibia intraarticular fractures using external fixator