Academic Journal
Complex humeral head fractures treated with blocked threaded wires: maintenance of the reduction and clinical results with two different fixation constructs
| العنوان: | Complex humeral head fractures treated with blocked threaded wires: maintenance of the reduction and clinical results with two different fixation constructs |
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| المؤلفون: | Gumina, Stefano, Candela, Vittorio, Giannicola, Giuseppe, Orsina, Luigi, Passaretti, Daniele, Villani, Ciro |
| المساهمون: | Gumina, Stefano, Candela, Vittorio, Giannicola, Giuseppe, Orsina, Luigi, Passaretti, Daniele, Villani, Ciro |
| بيانات النشر: | Mosby Inc. |
| سنة النشر: | 2019 |
| المجموعة: | Sapienza Università di Roma: CINECA IRIS |
| مصطلحات موضوعية: | Hertel 7 fracture, humeral head perfusion, Level III, percutaneous pinning, percutaneous wires fixation, plate fixation of humeral fracture, proximal humeral fracture fixation, Retrospective Cohort Design, shoulder fracture fixation, Three-part proximal humeral fracture, Treatment Study, Aged, 80 and over, Female, Fracture Fixation, Internal, Human, Humeral Fracture, Humeral Head, Male, Middle Aged, Radiography, Reconstructive Surgical Procedure, Bone Plate, Bone Wire, Surgery, Orthopedics and Sports Medicine |
| الوصف: | Background: Locking plates are the gold standard for treatment of 3-part humeral head fractures, although major complications range from 9% to 36%. Percutaneous techniques may allow vascular supply preservation, maintenance of fracture hematoma, scarce blood loss. Many configurations with Kirschner wires can be performed, generating confusion on result interpretation. We studied the correlation between system configuration, stability, and clinical results in patients with 3-part humeral head fractures treated with the same fixation system but with 2 different biomechanical constructs. Materials and methods: There were 52 consecutive patients (19 men, 33 women; mean age, 63.1 [standard deviation, 5.6] years; range, 48-82 years) with Hertel 7 humeral head fractures. Two fixation constructs composed of 3 couples (construct A) or 4 couples (construct B) of blocked threaded wires were used in 17 and 35 patients, respectively. At the final follow-up, the individual relative Constant Score (irCS) and visual analog scale were measured. Radiographic evaluation according to the Bahr criteria was performed. Statistical analysis was performed. Results: The mean follow-up was 22 months. The mean irCS at the final follow-up was 89.7%. The mean irCS in patients treated with construct A and construct B was 86% and 93%, respectively (P =.043). One nonunion and 2 superficial infections occurred (6%). The postoperative reduction was excellent in 97% of patients and remained excellent in 89%. The mean postoperative neck shaft angle was 135.0° (construct A: 134.7°; construct B: 135.1°), and the final neck shaft angle was 132.9° (construct A: 131.3°; construct B: 133.8°; P =.047). Conclusions: The functional and radiologic outcomes obtained with percutaneous fixation or locking plates are similar; however, the percentage of major complications after percutaneous treatment is lower. Results of percutaneous fixation depend on the biomechanical construct. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/30220496; info:eu-repo/semantics/altIdentifier/wos/WOS:000452710400011; volume:28; issue:1; firstpage:36; lastpage:41; numberofpages:6; journal:JOURNAL OF SHOULDER AND ELBOW SURGERY; http://hdl.handle.net/11573/1249702; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85053119970 |
| DOI: | 10.1016/j.jse.2018.06.034 |
| الاتاحة: | http://hdl.handle.net/11573/1249702 https://doi.org/10.1016/j.jse.2018.06.034 |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.EC8DFCC8 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jse.2018.06.034 |
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