Treatment of unusual proximal humeral fractures using unilateral external fixator: a case series.

Abstract

OBJECTIVE:

To report the functional and radiological results of unusual comminuted fractures of the proximal humerus, treated with 'closed reduction and external fixation' (CREF) using hybrid-type unilateral external fixators (EFs).

PATIENTS AND METHODS:

Between January 2012 and June 2013, eight patients (mean age 62.6; range 48-84 years) with comminuted proximal humeral fractures extending to the humeral head and one-third proximal diaphysis were treated with CREF using hybrid-type EFs. Functional results were evaluated in terms of shoulder ranges of movement, Constant, DASH, and VAS scores, and radiological results were evaluated using antero-posterior and lateral radiograms of the treated humerus.

RESULTS:

The mean follow-up was 16.6 (range 12-28) months. The mean fixator time was 84 (range 63-118) days. The mean range of forward flexion, internal rotation, external rotation, and abduction were 145°, 61.2°, 65°, and 115°, respectively. The mean Constant, DASH, and VAS scores were 79.8, 10, and 1.75, respectively. Seven of the eight patients (87.5 %) healed radiologically. Two complications were observed in two patients: non-union and superficial pin site infection.

CONCLUSIONS:

In the treatment of unusual, comminuted proximal diaphyseal humeral fractures, CREF using a hybrid-type EF is a minimally invasive, advantageous procedure with acceptable rates of healing, low risk of surgical site infection, and early range of motion.

LEVEL OF EVIDENCE:

Level IV, case series.

• Authors: Gökçer Uzer, Fatih Yıldız, Mehmet Elmadağ, Kerem Bilsel, Anil Pulatkan
• Journal: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie (Eur J Orthop Surg Traumatol) Vol. 25 Issue 4 Pg. 683-7 (May 2015) ISSN: 1432-1068 [Electronic] France
• PMID: 25524319 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• External Fixators
• Female
• Fracture Fixation (instrumentation, methods)
• Fracture Healing (physiology)
• Fractures, Ununited (etiology, physiopathology)
• Humans
• Male
• Middle Aged
• Prosthesis-Related Infections (etiology, physiopathology)
• Radiography
• Retrospective Studies
• Shoulder Fractures (diagnostic imaging, physiopathology, surgery)
• Treatment Outcome