Die kombinierte Humerusschaft- und proximale Gelenkfraktur View Full Text


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Article Info

DATE

2009-03-01

AUTHORS

J. Blum, M. Hansen, M.H. Hessmann, P.M. Rommens

ABSTRACT

Introduction and questionIntramedullary nailing is finding increasing acceptance for humeral shaft fractures. Recently, nailing systems have also been used for proximal metaphyseal humeral fractures. Which possibilities and clinical results are offered by intramedullary nailing of combined proximal and diaphyseal fractures of the humerus with titanium locking nails?Materials and methodsA prospective study with a standardized protocol was carried out with respect to the “unreamed humeral nail (UHN) with spiral blade” and its possible complications and clinical results between 1st October 2000 and 31st December 2005. There were 87 combined shaft and proximal humeral fractures in 28 male and 59 female patients with a median age of 69 years. Results were analyzed 1 year postoperatively in 72 patients according to the Constant-Murley score and x-rays.ResultsSignificant complications were bolt or spiral blade perforation of the articular surface (n=3), implant-related pain (n=2), fragment dislocation (n=1), non-union (n=1), humeral head necrosis (n=1) but no wound infection (n=0). The Constant-Murley score showed a median value of 71.2 for the injured side compared to 88.4 for the non-injured side, 1 year after the operation.DiscussionThe combination of diaphyseal and proximal-metaphyseal humeral fractures is a special challenge for the orthopaedic trauma surgeon, as even now the treatment of isolated proximal humeral fractures is not satisfactorily resolved in all cases. Open treatment such as plate osteosynthesis in general needs a long and invasive approach with corresponding biological disadvantages. Low invasive approaches for plates also have high risks on the humerus due to the specific neurovascular topography. In our study closed nailing showed good clinical and radiological results with low invasive approaches and complications mostly occurred in C-type fractures. If the use of additional cerclage wires for the diaphyseal component in nailing is deemed necessary, the biological benefits over plate osteosynthesis become less clear. More... »

PAGES

7-15

References to SciGraph publications

  • 2007-04-04. Intramedullary Nailing of Humeral Head and Humeral Shaft Fractures in EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
  • 2003-10. Internal Fixation of Proximal Humeral Fractures: Current Concepts in EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
  • 2001-11. Konservative oder operative Versorgung der Humeruskopffraktur beim alten Menschen? in DER CHIRURG
  • 2007-08. Osteosynthese instabiler proximaler Humerusfrakturen mit dem Targon®-PH-Nagel in OPERATIVE ORTHOPÄDIE UND TRAUMATOLOGIE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11678-009-0012-1

    DOI

    http://dx.doi.org/10.1007/s11678-009-0012-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1005153109


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