Surgical treatment of proximal humeral fracture with external fixator.
BACKGROUND
The treatment of unstable displaced proximal humeral fractures remains challenging and controversial. Reports about the application of a mini-external fixator in the treatment of proximal humeral fractures are rare. The objective of this retrospective study was to evaluate the efficacy and complications of surgical treatment of proximal humeral fractures by closed reduction and external fixation with application of a mini-external fixator.


METHODS
Thirty-two patients with displaced proximal humeral fractures were surgically treated by closed reduction and external fixation with mini-external fixators at our institute between March 2007 and June 2009. There were 22 men and 10 women who had a mean age of 56 years (range, 23-81 years). The Neer scoring system related to pain, function, and range of motion was used to assess the outcome.


RESULTS
All the patients were followed up at an mean of 18 months (range, 13-27 months). The duration of surgery was 29 ± 12 minutes. The accumulative fluoroscopy time was 12 ± 3.5 exposures. The mean time of fracture union was 13 ± 3.6 weeks. The mean Neer score was 83.2 ± 12.5 points at final follow-up. The incidence of excellent and good results was 81%. Two patients had loosening of the pins. One patient had a collapsed humeral head. There was no infection and impingement.


CONCLUSIONS
The surgical treatment of displaced proximal humeral fractures with a mini-external fixator is characterized by minimal invasion, a shorter duration of surgery, and easy manipulation, making application of the mini-external fixator a good option for some selected patients.
Department of Orthopaedic Surgery, Sixth Hospital of Ningbo, Ningbo, China. awei3@sohu.com
Jingwei
J
Zhang
Nabil
N
Ebraheim
Gregory E
GE
Lause
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D007593:Joint Instability / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult