Osteosynthesis techniques in proximal humeral fractures

Between March and October we prospectively reviewed 24 of 26 patients with proximal humerus fractures treated with a Philos plate. All cases of fractures of the proximal humerus treated with indication for osteosynthesis during that period were included.

The objective of this study was to describe the technique of using a fixed-angle plate with Philos locking screws and evaluate the results in 26 patients with traumatic injuries of the proximal humerus who underwent osteosynthesis using this type of implant.

Patients were followed on an outpatient basis with clinical and radiographic examination Figure 3. The aim of osteosynthesis is to promote stability allowing for early mobilization, and obtaining good positioning of the fractured fragments 2. The use of the plate and screw fixation method as an option is widespread among orthopedists.

The mean follow-up time was 12 months and the mean age of patients was 57 years. In patients younger than 50 years 11the automobile accident was the most common cause of fracture. This article has been cited by other articles in PMC. Abstract Describe the results of proximal humeral fractures surgically treated with the Philos locking plate system.

Fixed-angle plate with Philos locking screws was used as the fixation method for the proximal humerus.

All fractures showed union.

Three patients showed fracture union at varus position. Osteosynthesis with Philos plate provides a stable fixation method with good functional outcome.

The Philos Proximal Humeral Internal Locking System plate is an example of this new generation of implant plates with a locking system; it is considered a fixed-angle implant, whose design was based on the anatomy of the proximal humerus 4. The mean UCLA score for these patients was 27 points.

They are most common in the elderly; in the young, they are generally related to high-energy trauma 2. The mean UCLA score was 30 points The choice of the type of reduction or synthesis material to be used depends on the pattern of fracture, bone quality, age, and activity level of the patient 23.

The mechanism of fracture was a fall in 17 patients, car accident in five, and four different causes for the others.

Published online Nov Among the associated lesions, there was a case of pelvic bone fracture, a case of distal radius fracture, and one case of fracture of the cheekbone.

Whenever possible, the osteosynthesis is the option employed, since the functional results of hemiarthroplasty are not sufficiently satisfactory in most cases 2. Therefore, the fixed-angle locked plate was developed to allow for more stable fixation, especially in poor quality bone.

Most of these fractures are stable and with minimum deviation, and closed treatment is possible.

Once the criteria for surgical indication were met, osteosynthesis was performed using the fixed-angle plate with Philos locking screws Figure 2. The average age of patients was 57 years years.

Six patients had four-part proximal humerus fractures, 11 patients had three-part proximal humerus fractures, and nine patients had two-part proximal humerus fractures.

According to the Neer classification, nine fractures were classified into two parts, 11 in three parts, two of which were associated with anterior dislocation Figure 1and six in four parts, four of the valgus impacted type Table 1.

However, any method is subject to complications such as loosening of the fasteners, especially in older patients 3.Proximal humeral fractures account for about 5% of all extremity fractures and 70% of patients are at least 70 years of age (11). The prevalence of female gender ran-ges between 73 and 85% (4,11).

A year-old women with a life expectancy of 81 years has an estimated resi-dual lifetime risk of 8% of fracturing her proximal hume-rus (30).

Minimally invasive plate osteosynthesis in the treatment of proximal humeral fracture techniques and outcomes of those patients with proximal humeral shaft fractures treated by metaphyseal locking. The aforementioned transdeltoid lateral approach only provides limited access to the humeral head but can be used for osteosynthesis of the greater tuberosity or minimally invasive plate osteosynthesis (MIPO) of the proximal humerus.

NCB Proximal Humerus Osteosynthesis Plate Solution for Proximal Humerus Fractures The NCB-PH NCB® Proximal Humerus – Surgical Technique 5 * Not available in Europe, Middle East, and Africa proximal NCB screws once good fracture reduction has been achieved. 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.

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 .

Osteosynthesis techniques in proximal humeral fractures
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