REMOTE RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH PROXIMAL HUMERAL FRACTURES
Abstract
Proximal humeral fractures constitute 5-8% of all the fractures of the limbs and 80% of fractures of the upper arm. To report about remote results of the suggested tactics of surgical treatment of proximal humeral fractures. Satisfactory results of treatment were found in 21 (80,7%) patients out of 26 (72%), who underwent closed reduction of fractures with pin fixation. This group of patients achieved consolidation in optimal terms, and the function of the shoulder joint was satisfactory with abduction angle of 90°. 2 (7,7%) patients experienced secondary dislocation of fragments and their QuickDASH score was 38.4. 3 (11,6%) patients achieved consolidation of fracture, but stable contracture of the shoulder joint occurred. Their QuickDASH score was 38.4. Osteosynthesis with plates was performed in 10 patients. 3 (30%) of them developed aseptic necrosis of the humeral bone head, 2 (20%) patients developed suppuration of the soft tissues which produced a negative effect of the patients’ ability to work ‒ QuickDASH score 42,7, 5 (50%) patients admitted satisfactory results of treatment ‒ QuickDASH score 21,5. Osteosynthesis with plates was performed in 10 patients. 3 (30%) of them developed aseptic necrosis of the humeral bone head, 2 (20%) patients developed suppuration of the soft tissues which produced a negative effect of the patients’ ability to work ‒ QuickDASH score 42,7, 5 (50%) patients admitted satisfactory results of treatment ‒ QuickDASH score 21,5. The tactics of surgical treatment of patients with proximal humeral fractures
depends on the following: type of a fracture, patient’s age, concomitant pathology and osteoporosis available, and patient’s social needs.
References
Ковальчук В.М. Результати хірургічного лікування внутрішньо суглобових переломів проксимального відділу плечової кістки// Український науково-медичний молодіжний журнал . — 2013. № 1. — С. 62-65.
Литвин Ю.П., Пивень Ю.Н. Оперативная техника при трех- и четырехфрагментарных переломах проксимального отдела плечевой кости // Травма. — 2010. — Т. 11, № 4. — С. 452-455
Лоскутов А.Е., Томилин В.Н. Эндопротезирование при полифрагментарных переломах головки плечевой кости // Травма. — 2010. — Т. 11, № 4. — С. 436-440.
Страфун С.С. Аналіз причин розвитку остеоартрозу плечового суглоба у хворих після переломів проксимального епіметафіза плечової кістки / Страфун С.С., Богдан С.В., Юрійчук Л.М., Сергієнко Р.О. Вісник ортопедії, травматології та протезування, 2020, №1: 15-24.
Сухин Ю.В., Павличко Ю.Ю. Нарушение кровоснабжения проксимального отдела плечевой кости при различном характере его повреждения // Травма. — 2008. — Т. 9, № 3. — С. 257-259
Alberio R. L. Minimally invasive plate osteosynthesis for proximal humerus fractures: a retrospective study describing principles and advantages of the technique / R. L. Alberio, M. Del Re, F. A. Grassi // Advances in Orthopedics. — 2018. — Vol. 2018.— Article ID: 5904028. — DOI: 10.1155/2018/5904028.
Bigliani L. U. Fractures of the proximal humerus / L. U. Bigliani, E. L. Flatow, R. G. Pollock // Rockwood and Greenʼs Fractures in Adults / C. A. Rockwood, D. P. Green, R. W. Bucholz, J. D. Heckman. — 4th ed. — Philadelphia: Lippincott-Raven Publishers, 1996. — P. 1055–1107.
Fialka C. Modification of the Constant-Murley shoulder scoreintroduction of the individual relative Constant score Individual shoulder assessment / Fialka C., Oberleitner G., Stampfl P. [et al.] // Injury. - 2005. - Vol. 36, № 10. - P. 1159-65.
Gerber C. Internal fixation of complex fractures of the proximal humerus / C. Gerber, C. M. Werner, P. Vienne // Journal of Bone and Joint Surgery. Br. — 2004. — Vol. 86 (6). — P. 848–855.
Jabran A. Biomechanical analysis of plate systems for proximal humerus fractures: a systematic literature review / A. Jabran, C. Peach, L. Ren // BioMedical Engineering OnLine. — 2018. — Vol. 17. — Article ID: 47. — DOI: 10.1186/s12938-018-0479-3.
Liew A. S. Effect of screw placement on fixation in the humeral head / A. S. Liew, J. A. Johnson, S. D. Patterson [et al.] // Journal of Shoulder and Elbow Surgery. — 2000. — Vol. 9 (5). — P. 423–436. — DOI: 10.1067/mse.2000.107089
Neer C.S., II. Displaced proximal humeral fractures. Part I. Classification and evaluation // J. Bone Joint Surg (Am). — 1970. — Vol. 52-A, № 6. — P. 1077-1089.
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