APPLICATION OF THE AXIAL STABLE PLATE IN FRACTURES OF PROXIMAL HUMERUS
Authors:
M. Křivohlávek; R. Lukáš; S. Taller; J. Šrám
Authors place of work:
Trauma centre of District Hospital of Liberec
; Traumacentrum Krajské nemocnice Liberec
Published in the journal:
Úraz chir. 13., 2005, č.2
Summary
Treatment of fractures of the upper end of the humerus is often difficult because they frequently occur in older age groups with advanced osteoporosis. Common methods of stable osteosynthesis may fail owing to the low density of the skeleton and due to problemmatic fixation of small fragments. The plate Philos (Synthes) which uses the principle of locking screws (LCP) is an implant that is stable enough for these problematic fractures.
The authors evaluated a group of 33 patients operated on at the Trauma Centre of the District Hospital of Liberec from August 2002 to November 2004. The group included 23 female and 10 male patients, average age 57,8 years (64,7 female, 42,9 male).
In 24 patients, monitored minimally over three months, functional results were evaluated according to the ConstantMurley Score in a prospective study. The average value of the CostantMurley Score was 79,3 (range 61–100), in fractures Neer 4 score 82,9 (6496 ), Neer 5 score 72,3 (19–97) and in luxation fractures Neer 6 score was 61,9 (36–79).
Application of the axially stable plate Philos represents the method of choice for dislocated fractures of the proximal humerus in cases of marked osteoporosis, in three and four fragment fractures and in cases of broken head of humerus.
Key words:
fractures of proximal humerus, axially stable implant, LCP.
Zdroje
1. BARTONÍČEK, J., STEHLÍK, J., DLOUHÝ, M. Osteosyntéza zlomenin proximálního konce humeru modifikovanou dlahou. Acta Chir Orthop Traumatol Cech. 62, 1995, 3, 207–220.
2. CONSTANT, C.R., MURLEY A.H. A clinical method of functional assessment of the shoulder. Clin Orthop. 216, 1987, 91–110.
3. FRANKHAUSER, F., BOLDIN, C., SCHIPPINGER, G. et al. A new locking plate for unstable fractures of the proximal humerus. Abstract book. Osteosynthese International. Graz 2004. s. 50.
4. FRIČ, V., SOSNA, A. Příspěvek k problematice klasifikací zlomenin proximálního konce humeru u dospělých. Acta Chir Orthop Traumatol Cech. 62, 1995, 3, 196–206.
5. GOTZEN, L., BAHRS, CH., LEPPEK, R. et al. Suggestion for a modular topographicmorphologic classification of proximal humeral fractures. Eur J Trauma. 29, 2003, 1, 31–41.
6. HANDSCHIN, A.E., CONTALDO, C., LABLER, L. et al. Functional results of angularstable plate fixation in displaced proximal humeral fractures. Abstracts. European J Trauma. 6th European Trauma Congress. 30, 2004, Suppl. 1., 22.
7. HESSEMAN, M., STERNSTEIN, W., BLUM, J. et al. Die winkelstabile Plattenosteosynthese am proximalen Humerus. Akt Traumatol. 33, 2003, 1, 2–6.
8. HESSEMAN, M., BLUM, J., HOFMANN, A., et al. Internal fixation of proximal humeral fractures: Current concepts. Eur J Trauma. 29, 2003, 5, 253–261.
9. HOFFMEYER, P. The operative management of displaced fractures of the proximal humerus. J Bone Joint Surg. 84, 2002, 4, 469–480.
10. KÖSTLER, W., STOHRM, P.C., SÜDKAMP, N.P. Welche Vorteile bietet das winkelsteife Implant am proximalen humerus? OPJournal. 20, 2004, 1, 14–17.
11. KŘIVOHLÁVEK, M., ŠRÁM, J., TALLER, S., LUKÁŠ, R. Úhlově stabilní implantáty pro zlomeniny proximálního humeru – prospektivní studie – předběžné výsledky. Souhrny přednášek. Úhlově stabilní implantáty v ošetřování zlomenin dlouhých kostí. Liberec 2004.
12. LEBEDOVÁ, H., KUČERA, L., KŘIVOHLÁVEK, M. Rehabilitace po zlomeninách proximálního humeru. Souhrny přednášek. Úhlově stabilní implantáty v ošetřování zlomenin dlouhých kostí, Liberec 2004.
13. LILL, H., HEPP, P., HOFFMANN, J., et al. Neue Implantate zur Stabilisierung proximaler Humerusfrakturen. Osteosyntese International. 9, 2001, 2, 85–93.
14. LILL, H., HEPP, P., ROSE, Z. et al. The angle stable lockingproximalhumerusplate (LPHP) for proximal humeral fractures using a small anteriorlateraldeltoidsplittingapproach technique and first results. Zentralbl Chir. 129, 2004, 1, 43–48.
15. MAURER, J., RÜTER, A.E. Winkelstabile Plattenosteosynthese am proximalen Humerus. Trauma und Berufskrankheit. 6, 2004, Suppl. 2, 247–250.
16. MITTLMEIER, W.F., Stedfeld, H.W., EWERT, A. et al. Stabilization of proximal humeral fractures with an angular and sliding stable antergade locking nail (Targon PH ). J Bone Joint Surg. 85A, 2003, Suppl. 4, 136–146.
17. NEER, C.S. Displaced proximal humeral fractures I. Classification and evalution. J Bone Joint Surg. 52A, 1970, 6, 1077–1089.
18. NEER, C.S. Displaced proximal humeral fractures II. Treatment of Threepart and Fourpart Displacement. J Bone Joint Surg. 52A, 1970, 6, 1090–1103.
19. POPELKA, V. Súčasný stav ošetrovania zlomenín proximálneho humeru u pacientou v dospelom veku praktická časť. Úraz chir. 12, 2004, 2, 16–26.
20. SCHWARTZ, C., CUNY, C. Fractures of the proximal humerus: a prospective review of 188 cases, Eur J Orthop Surg Traumatol. 13, 2003, 1, 1–12.
21. SOSNA, A. ČECH, O. Operační přístupy ke skeletu pohybového aparátu. 1. vyd. Praha: Avicenum, 1987. 273 s.
22. SÜDKAMP, N.P. Erste Erfahrungen mit winkelstabilen Implantaten. Trauma und Berufskrankheit. 6, 2004, Suppl. 1, 13–18.
23. TALLER, S., LUKÁŠ, R., ŠRÁM, J. et al. Akutní úrazová hemiartroplastika ramenního kloubu – operační technika. Úraz Chir. 4, 1996, 4, 4–7.
24. TAMAI, K., HAMADA, J., OHNO, W. et al. Surgical anatomy of multipart fractures of the proximal humerus. J Shoulder Elbow Surg. 11, 2002, 5, 421–427.
25. WAHLER, G., NEUBAUER, T., WAGNER, M. The deltoid splitting access in fixation of humeral head fractures with locked plates. An alternative to the standard deltopectoral Access? Abstracts. Eur J Trauma. 6th European Trauma Congress. 30, 2004, Suppl. 1, s. 85.
26. WIJGMAN, A.J., ROOLKER, W., PATT, T.W. et al. Open reduction and internal fixation of three and four part of the humerus. J Bone Joint Surg. 84A, 2002, 11, 1919–1925.
Štítky
Surgery Traumatology Trauma surgeryČlánok vyšiel v časopise
Trauma Surgery
2005 Číslo 2
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
- Obstacle Called Vasospasm: Which Solution Is Most Effective in Microsurgery and How to Pharmacologically Assist It?
Najčítanejšie v tomto čísle
- DOES FIBULAR FIXATION AFFECT THE TREATMENT OUTCOME OF DISTAL THIRD TIBIAL SHAFT FRACTURES?
- UNUSUAL SOLUTION TO SERIOUS TRAUMA OF THE PATELLA – A CASE REPORT
- APPLICATION OF THE AXIAL STABLE PLATE IN FRACTURES OF PROXIMAL HUMERUS
- TACTICS OF TREATMENT FOR OPEN FOREARM FRACTURES GRADE IIIB