[Minimally invasive T-plating at the proximal humerus].
BACKGROUND
A generally accepted recommendation for the optimum surgical treatment of unstable, dislocated fractures of the proximal humerus is not yet available. According to the general surgical trend to minimally invasive techniques, the object of this study was to conduct follow-up examinations of the technique of minimally invasive T-plating at the proximal humerus developed at our hospital and to compare the results with those of other osteosynthetic techniques, especially concerning the complications of the surgical approach and the clinical outcome.


METHODS
Between 1/2000 and 6/2003, 117 minimally invasive T-plating procedures were performed on 116 patients by sliding through a T-plate from a small proximal incision. After application of the exclusion criteria, a total of 100 operations on 99 patients were left. The follow-up examinations were based on the Constant score and the DASH score.


RESULTS
At an average value of 70 points (SD +/- 21), the results of the Constant-Murley score were only medium to satisfactory (min. 17/max. 100 points). At an average value of 32 points (SD +/- 23), the results of the DASH score also were only adequate (min. 0/max. 78 points). A correlation between age, sex or fracture classification and the score results could not be deduced.


CONCLUSIONS
The expectations for this technique were not met. Minimally invasive T-plating could not be shown to be superior to other techniques.
Klinik für Unfall-, Hand- und Orthopädische Chirurgie, Städtisches Klinikum Karlsruhe. ortho-trauma@klinikum-karlsruhe.de
M
M
Fassbender
G
G
Rothenbacher
C
C
Weschler
C A
CA
Müller
U
U
Pfister
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*