[Crossed screw osteosynthesis of proximal humerus fractures].
Between March 1997 and October 1999 thirty-one patients with displaced proximal humeral fractures were treated with crossed screw osteosynthesis. Insertion of the screws was realized by using a deltoideo-pectoral approach placing the screws anteriorly and posteriorly in a crossed manner from the distal fragment into the humeral head. Additionally, in all two-part-fractures a tension band was applied. In all three-part-fractures, the greater tuberosity was reattached by additional screws. In 21 patients (14 female, 7 male, median age 62 years, 18-86) a clinical and radiological follow-up (median 18 months, 10-29) was obtained. Fractures were classified as two-part-fractures in 10 patients and as three-part-fractures in 11 patients. According to the Constant-Score, "excellent" and "good" results were achieved in 15 patients, "moderate" results were found in 3 patients. However, in 3 patients results were only "poor" (1 two-part-, 2 three-part-fractures). The complication rate was 29% (premature hardware removal due to head perforation in 3 cases; humeral head necrosis necessitating prosthetic replacement in 2 patients; secondary displacement in 1 case). Crossed screw osteosynthesis represents an justified alternative in the surgical treatment of displaced proximal humeral fractures permitting early functional therapy.
Lill
H
H
Klinik für Unfall- und Wiederherstellungschirurgie, Universität Leipzig, Liebigstrasse 20a, 04103 Leipzig. lill@medizin.uni-leipzig.de
Korner
J
J
Glasmacher
S
S
Hepp
P
P
Just
A
A
Verheyden
P
P
Josten
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D020878:Device Removal; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome