External fixation for displaced 2-part proximal humeral fractures. 2012

Ioannis S Benetos, and Panayiotis K Karampinas, and Andreas F Mavrogenis, and Pavlos Romoudis, and Spiros G Pneumaticos, and John Vlamis
Third Department of Orthopaedics, Athens University Medical School, KAT Hospital, Athens, Greece. ioannisbenetos@yahoo.gr

Studies have reported conflicting results regarding external fixation for displaced proximal humeral fractures. Compared with open reduction and internal fixation, external fixation for displaced proximal humeral fractures avoids dissection and soft tissue stripping and leads to higher union rates, a lower incidence of avascular necrosis, less scaring of the scapulohumeral interface, and faster rehabilitation. Some authors have reported good or excellent results and minimum complications compared with open reduction and internal fixation; however, others have reported that external fixation does not ensure acceptable reduction and fracture stability, especially in patients with osteoporosis.This article describes 18 patients with displaced 2-part fractures of the surgical neck of the humerus treated with closed reduction and external fixation using the Tension Guide Fixator (Gexfix SA, Carouge, Switzerland) external fixation system between 2010 and 2011. The patients included 14 women and 4 men with a mean age of 39 years. Mean follow-up was 18 months (range, 15-24 months). Fracture union; function using the Constant score, University of California Los Angeles score, Oxford score, and Quick Disabilities of the Arm, Shoulder and Hand shoulder score; and complications were evaluated. All patients experienced fracture union at a mean of 11 weeks (range, 9-13 weeks). The Tension Guide Fixator was removed without anesthesia at the outpatient clinic at a mean of 6 weeks (range, 4-8 weeks) with no loss of reduction or secondary displacement after removal. At 1-year follow-up, mean Constant and University of California Los Angeles scores were excellent, mean Oxford score showed satisfactory joint function, and mean Quick Disabilities of the Arm, Shoulder and Hand score showed minimal pain with no disability.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D001864 Bone Wires Steel wires, often threaded through the skin, soft tissues, and bone, used to fix broken bones. Kirschner wires or apparatus also includes the application of traction to the healing bones through the wires. Kirschner Wire,Kirschner Wires,Bone Wire,Wire, Bone,Wire, Kirschner,Wires, Bone,Wires, Kirschner
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D005260 Female Females
D005592 Fracture Fixation The use of metallic devices inserted into or through bone to hold a fracture in a set position and alignment while it heals. Skeletal Fixation,Fracture Reduction,Fixation, Fracture,Fixation, Skeletal,Fixations, Fracture,Fixations, Skeletal,Fracture Fixations,Fracture Reductions,Reduction, Fracture,Reductions, Fracture,Skeletal Fixations
D005596 Fractures, Closed Fractures in which the break in bone is not accompanied by an external wound. Fractures, Occult,Closed Fracture,Closed Fractures,Fracture, Closed,Fracture, Occult,Occult Fracture,Occult Fractures
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000058 Accidental Falls Falls due to slipping or tripping which may result in injury. Falls, Accidental,Falling,Falls,Slip and Fall,Accidental Fall,Fall and Slip,Fall, Accidental

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