Cementless anatomical prosthesis for the treatment of 3-part and 4-part proximal humerus fractures: cadaver study and prospective clinical study with minimum 2 years followup
نویسندگان
چکیده
INTRODUCTION The purpose of this study was to evaluate the functional and radiological outcomes of a cementless, trauma-specific locked stem for 3- and 4-part proximal humeral fractures. MATERIALS AND METHODS This study consisted of two parts: a cadaver study with 22 shoulders and a multicenter prospective clinical study of 23 fracture patients evaluated at least 2 years after treatment. In the cadaver study, the locked stem (Humelock(TM), FX Solutions) and its instrumentation were evaluated. In the clinical study, five senior surgeons at four different hospitals performed the surgical procedures. An independent surgeon evaluated the patients using clinical (Constant score, QuickDASH) and radiological (X-rays, CT scans) outcome measures. RESULTS The cadaver study allowed us to validate the height landmarks relative to the pectoralis major tendon. In the clinical study, at the review, abduction was 95° (60-160), forward flexion was 108° (70-160), external rotation (elbow at body) was 34° (0-55), the QuickDASH was 31 (4.5-59), the overall Constant score was 54 (27-75), and the weighted Constant score was 76 (31.5-109). DISCUSSION This preliminary study of hemiarthroplasty (HA) with a locked stem found results that were at least equivalent to published series. As all patients had at least a 2-year follow-up, integration of the locked stem did not cause any specific complications. These results suggest that it is possible to avoid using cement when hemiarthroplasty is performed for the humeral stem. This implant makes height adjustment and transosseous suturing of the tuberosities more reproducible.
منابع مشابه
The Outcome of Proximal Humeral Locking Plates in the Management of Three and Four Part Proximal Humeral Fractures in Special Cohort of Young Patients in High Velocity Trauma
Background: Locking plate fixation provides satisfactory outcome following proximal humerus fractures. None of theprevious studies selectively evaluate the outcome in young patients. This study evaluates outcome of locking platesystem in the treatment of acute three- and four-part fractures in young patients.Methods: In this prospective study we included all patients who were less than 60 years...
متن کاملبررسی نتایج درمانی شکستگیهای 3 و 4 قطعهای قسمت فوقانی استخوان بازو به روش بخیهزدن قطعات به یکدیگر
Optimal treatment of 3 and 4-part fractures of the proximal humerus is still controversial and is accompanied with many complications. These fractures can be treated with variety of osteosynthetic methods especially in younger ages, but some complications such as limited range of motions, mal:::union:::s and avascular necrosis are common. Hemiarthroplasty can be used in old patients wit...
متن کاملConservative treatment, plate fixation, or prosthesis for proximal humeral fracture. A prospective randomized study
BACKGROUND Proximal humerus fracture is the third most common fracture type after hip and distal radius fracture in elderly patients. A comprehensive study by Palvanen et al. demonstrated an increase in the annual fracture rate of 13.7% per year over the past 33 years. Should this trend continue, the fracture rate would triple over the next three decades. The increasing incidence of low-energy ...
متن کاملOpen reduction and Internal Fixation of Displaced Proximal Humerus Fractures with AO Stainless Steel T-Plate
ABSTRACT BACKGROUND Proximal humeral fractures are considered the last unsolved fractures in orthopaedics. The treatment is controversial and various operative modalities have been reported in the literature. The aim of the present study was to evaluate functional outcome and complication rate after open reduction and internal fixation of displaced proximal humerus fractures by proximal hume...
متن کاملRisk factors of loss reduction after percutaneous fixation in supracondylar humerus in pediatric: a descriptive-analytical study
Background & Aims: supracondylar humerus fracture is one of the most common pediatric elbow fractures accounting for about 16% of the pediatric fractures. Loss of reduction is one of the complications after closed and percutaneous fixation. This research is aimed to investigate the factors involved in the loss of reduction. Method: In this descriptive study, the children with supracondylar hum...
متن کامل