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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2009 April;60(2):99-103
Proximal humerus fractures: clinical and radiographical results with different ostheosynthesis techniques
Pappalardo S., Braidotti P., Ceretti M., Manauzzi E.
Unità Operativa Complessa di Traumatologia d’Urgenza DEA 2 Università di Roma “La Sapienza” Policlinico Umberto I, Roma, Italia
Aim. The target of this study was to establish which is the best approach to identify the right therapeutic and classificative strategy for proximal humerus fractures.
Methods. The study was performed on 66 patients, 51 women and 15 men, with an average age of 72.57 years and a medium follow-up of 18.4 months. At the first aid the following clinical diagnosis have been formulated: Neer II fractures in 31 patients, Neer III fractures in 5 patients, Neer IV fractures in 10 patients. The treatment most frequently used has been with closed sky surgery; 17 patients were operated with Kirschner wires, 26 with nails, 3 with free screws ostheosynthesis, 2 with arthroplsty, 4 with tension graduate fixation (TGF) gexfix exfix external fixation.
Results. The Constant Score was 72.63/100. The postoperative surgery complications have been infection in 2 cases, one wire migration, one secondary fracture decomposition, only one humeral head necrosis.
Conclusion. The results obtained are to be considered also on the basis of the patients’ average age (72.57 years). This is due to a good postoperative rehabilitation and to the new low invasives surgery techniques used. Therefore close sky reduction and percutaneus Kirschner wires or nails synthesis have decreased the vascular and infective complications risk. The method used seems to guarantee a good compromise between radiographical and clinical results in older or ostheoporotic patients.