title: The importance of inferomedial support in the hot air balloon technique for treatment of 3-part proximal humeral fractures.
abstract: OBJECTIVE
  Inferomedial support may affect the results of the hot air balloon technique for the treatment of displaced, 3-part fractures of the proximal humerus.
  
  
  METHODS
  Forty-three patients with displaced, 3-part fractures of the proximal humerus treated with the hot air balloon technique between 1995 and 2007 were included in the study. All patients were classified into 4 subgroups based on the presence or absence of medial buttress restoration and inferomedial screw insertion (R+, restored with inferomedial screw; R-, restored without inferomedial screw; NR+, non-restored with inferomedial screw; and NR-, non-restored without inferomedial screw). Assessment of radiologic and clinical outcome among subgroups was based on evaluation of neck-shaft angle, American Shoulder and Elbow Surgeons score, and Neer score.
  
  
  RESULTS
  The mean follow-up duration was 65 ± 29.7 months. The change in the neck-shaft angle in the R+, R-, NR+, and NR- groups was 3°, 2°, 3°, and 11°, respectively. The mean American Shoulder and Elbow Surgeons scores in the R+, R-, NR+, and NR- groups were 91 ± 4.8, 86 ± 5.4, 85 ± 1.9, and 77 ± 5.8, respectively. The mean Neer scores in the R+, R-, NR+, and NR- groups were 92 ± 4.3, 88 ± 4.0, 87 ± 2.1, and 76 ± 8.2, respectively.
  
  
  CONCLUSIONS
  Medial buttress restoration and inferomedial screw insertion affect bone-nail construct stability and clinical outcomes.
authors: Shoulder, Elbow and Sports Service, Department of Orthopaedic Surgery, Konkuk Medical School, Seoul, South Korea.
authors: Jin-Young
authors: JY
authors: Park
authors: Jung-Han
authors: JH
authors: Kim
authors: Sang-Hoon
authors: SH
authors: Lhee
authors: Seung Jun
authors: SJ
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D016022:Case-Control Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000601:surgery*; D013537:Sutures; D055815:Young Adult