Journal of Musculoskeletal Trauma

Comparison of Results between Internal Plate Fixation and Hemiarthroplasty in Comminuted Proximal Humerus Fracture: Doo Sup Kim, Dong Kyu Lee, Chang Ho Yi, Jang Hee Park, Jung Ho Rah; J Korean Fract Soc 2011;24(2):144-150. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.144

PURPOSE
Authors compare clinical and radiological results of internal fixation group and hemiarthroplasty group for comminuted proximal humerus fracture to find out which the treatment method have to be chose for comminuted proximal humerus fractures.
MATERIALS AND METHODS
Patients who were treated from March 2005 to March 2007 and available for 2 years follow-up were targets of this study. The internal fixation group had 38 cases, and hemiarthroplasty group included 26 cases. The results were analyzed both clinically and radiologically.
RESULTS
On average, Bone union took 15.6 weeks in the internal fixation group. Constant score between the internal fixation and hemiarthroplasty groups were on average 75+/-6.5 points and 70+/-7.4 points (p=0.034). In 3-part fracture, Constant score between both groups were 78+/-5.4 points from the former and 71+/-2 points, respectively (p=0.028). In 4-part fracture group, Constant score were 72+/-8 points for the internal fixation group and 69+/-9.2 points for the hemiarthroplasty group (p=0.041).
CONCLUSION
Internal plate fixation can gain better outcome than hemiarthroplasty in 4-part fracture as well as 3-part fracture of proximal humerus by careful dissection for preservation of blood supply for humeral head and optimal reduction.

Citations

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Surgical treatment of proximal humerus fractures: a systematic review and meta-analysis
Erik Hohmann, Natalie Keough, Vaida Glatt, Kevin Tetsworth
European Journal of Orthopaedic Surgery & Traumatology.2022; 33(6): 2215. CrossRef
Effectiveness and Safety of Interventions for Treating Adults with Displaced Proximal Humeral Fracture: A Network Meta-Analysis and Systematic Review
Long Chen, Fei Xing, Zhou Xiang, Ara Nazarian
PLOS ONE.2016; 11(11): e0166801. CrossRef
Meta-analysis comparing locking plate fixation with hemiarthroplasty for complex proximal humeral fractures
Jiezhi Dai, Yimin Chai, Chunyang Wang, Gen Wen
European Journal of Orthopaedic Surgery & Traumatology.2014; 24(3): 305. CrossRef

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Proximal Humeral Fracture with Epiphyseal Plate Injury: Sung Kwan Hwang, Jin Rok Oh, Jung Ho Rah, Ki Ho Kim; J Korean Soc Fract 1997;10(4):793-800. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.793

Abstract PDF: Proximal humerus fracture with epiphyseal plate injury does not cause the growth disturbances and deformity of humerus in comparison with other fracture of epjphyseal plate. The explanation about this phenomenon is that the fracture occurs microscopically in maturing Bone near provisional calcifying zone, another explanation is that the epiphyseal plate in proximal humerus greatly contribute the longitudinal growth of humerus and has trimendous remodelling potential. In this study, we experienced the 25 cases of proximal humeral epiphyseal injury from January, 1991 to June, 1997 We analyzed the growth disturbance and deformity of the proximal humeral epiphyseal plate in regard to age, fracture type, treatment method of the 15 cases with 3 years follow-up among the 25 cases. This fracture is most common in the age of 13 to 16, 11 cases among total 15 cases(75 percent). Most common fracture type is type II by Salter-Harris classification, 14 cases among total 15 cases, 3 cases is type IV by Neer-Horowitz classification, where, manual reduction was impossible because of interposition with biceps tendon between fracture fragments. There was no impairment of motion, growth distrubance and deformity in all cases. We concluded there is no direct correlation with patient age, the degree of fracture, displacement, treatment method in view of gorwth disurbance and deformity.

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Refracture of the Femur after Plate Removal: Sung Kwan Hwang, Jung Ho Rah, Hee Jeon Park, Yeo Seung Yoon, Jae Beom Han; J Korean Soc Fract 1995;8(4):799-806. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.799

Abstract PDF

Internal fixation with dynamic compression plate is an accepted method of treating diaphyseal fractures of the adult femur. Good results have been reported using the principles laid down by the AO group(Muller et al 1979). Refracture after secure union of a broken femur has been achieved is rare, but it is most devastating complication. There were 5 refractures out of 64 removals after fractures of the femur at the department of Orthopaedic Surgery, Yonsei University Wonju college of Medicine between January, 1988 and June, 1994. After clinical and roentgenographical analysis, following results were obtained. 1. The causes of the refracture were trivial injuries or slip down injury. 2. Among 5 cases, the average time from insertion to removal was 19.2 months, with a ranged from 16 to 28 months. 3. The internal from removal of implant to refracture was 5.6 wks, with a range from 3 to 9 weeks. 4. The incidence of refracture in out hospital(7.8%) was somewhat higher than reported incidence by others. 5. The femur plates should not be removed prior to 2 years postoperatively and its removal should be postponed, if possible. 6. It is reasonable to postpone its removal until bone strength is adequate for full activity.

Citations

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Refractures of the Upper Extremity in Children
Hui Wan Park, Ick Hwan Yang, Sun Young Joo, Kun Bo Park, Hyun Woo Kim
Yonsei Medical Journal.2007; 48(2): 255. CrossRef

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