Helical plate fixation for treatment of comminuted fractures of the proximal and middle one-third of the humerus.
When an operative treatment is indicated for comminuted fractures of the proximal and middle one-third of the humerus, plate fixation is one of the better options. However, a long plate must be applied from the lateral aspect of the greater tuberosity to the shaft of the humerus, which requires dissection of the deltoid muscle insertion. We twisted the long plate and fixed it from the lateral aspect of the greater tuberosity to the anterior or antero-medial aspect of the mid or the distal shaft of the humerus preserving the deltoid muscle insertion in nine patients (10 limbs). Eight out of 10 cases involved comminuted segmental fractures of the proximal humeral shaft, the surgical neck, and the greater tuberosity. Tricortical autoiliac bone graft was necessary in two patients to restore the neck-shaft angle. All fractures healed uneventfully at 19 weeks on average without additional procedure (range: 14-28 weeks). Shoulder function was evaluated according to Neer's criteria. Three patients were classified as excellent, five satisfactory, and as two unsatisfactory, there was no failure.
Yang
Kyu Hyun
KH
Department of Orthopaedic Surgery, Youngdong Severance Hospital, Yonsei University College of Medicine, Youngdong P.O. Box 1217, Seoul, Republic of Korea. kyang@yumc.yonsei.ac.kr
D000328:Adult; D001860:Bone Plates; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012785:Shoulder Joint / Q000503:physiopathology; D016896:Treatment Outcome