title: Valgus impacted proximal humeral fractures and their blood supply after transosseous suturing.
abstract: We treated 16 patients (11 women and five men, average age 45 years), all having four-part valgus impacted fractures of the proximal humerus, with transosseous suturing. All had preoperative angiography performed 6-12 h after admission. The average impaction angle was 43 degrees , and the mean lateral displacement of the humeral head was 1.4 mm. Postoperative angiography was performed 8-10 weeks after the operation followed by digital image processing using the segmentation technique. No statistically important reduction in the length and area of large (>0.5 mm) vessels was seen. Union was confirmed by the reduction in the length and area of small vessels (<0.5 mm). At a mean follow-up of 40 months, avascular necrosis was only found in one patient. The average Constant-Murley score was 87 (67-100) points, whereas the functional score in comparison with the unaffected shoulder was 94% (89-100%). Despite the small number of patients, transosseous fixation seems to preserve the remaining blood supply of the humeral head.
authors.affiliation: Department of Orthopaedic, Patras University Hospital, 26504, Rio-Patras, Greece. andpan21@medscape.com
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Panagopoulos
authors.forename: P
authors.initials: P
authors.lastname: Dimakopoulos
authors.forename: M
authors.initials: M
authors.lastname: Tyllianakis
authors.forename: D
authors.initials: D
authors.lastname: Karnabatidis
authors.forename: D
authors.initials: D
authors.lastname: Siablis
authors.forename: A X
authors.initials: AX
authors.lastname: Papadopoulos
authors.forename: E
authors.initials: E
authors.lastname: Lambiris
authors.forename: P
authors.initials: P
authors.lastname: Kraniotis
authors.forename: G
authors.initials: G
authors.lastname: Sakellaropoulos
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006811:Humerus / Q000098:blood supply / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012784:Shoulder Fractures / Q000601:surgery*; D013536:Suture Techniques