Journal of Musculoskeletal Trauma

Original Articles

Two-part and Three-part Fractures of the Proximal Humerus Treated with the Polarus Interlocking Nail: A Comparison of Fracture Types: Kyu Cheol Noh, Yung Khee Chung, Kook Jin Chung, Sung Ku Hong; J Korean Fract Soc 2006;19(2):182-187. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.182

PURPOSE
To evaluate the radiographic and clinical outcomes of patients with displaced proximal humerus fractures (two-part and three-part) treated with the Polarus interlocking nail, comparing their fractures types.
MATERIALS AND METHODS
There were 22 patients with displaced proximal humerus fractures. There were 10 surgical neck (SN) and 1 anatomical neck (AN) two-part fractures and 10 greater tuberosity/surgical neck (GT/SN) and 1 GT/AN three-part fractures. All patients were surgically treated solely with the Polarus interlocking nail using a closed technique. Functional assessment was obtained using the American Shoulder and Elbow Surgeons (ASES) score, which grade outcomes as excellent (>75), satisfactory (50~75), poor (<50) results. Radiographic outcome measurements included fracture alignment (neck-shaft angle), loosening of screw, fixation and hardware failure, and malunion and nonunion.
RESULTS
Overall, the average ASES score was 80.2 (range 46.0 to 98.0). There were 15/22 (68.2%) excellent, 6/22 (27.3%) satisfactory, and 1/22 (4.5%) poor results. All shoulders healed radiographically without evidence of avascular necrosis of the humeral head. When comparing patients with two-part fractures (n=11) with patients having three-part fractures (n=11), there were statistically significant differences with ASES outcome measures (p<0.05). But, there were no statistically significant differences in age-related analysis (p>0.05).
CONCLUSION
Both displaced two-part fractures and three-part GT/SN fractures can have above satisfactory functional and radiographic outcomes with the Polarus interlocking nail using a closed technique. Even though displaced three-part GT/SN fractures in elderly osteopenic patients (>60 years), we treated successfully with the Polarus interlocking nail.

Citations

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Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis
Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee
Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef
Intramedullary Nailing for Complex Fractures of the Proximal and Midshaft of the Humerus
Chul-Hyun Cho, Gu-Hee Jung, Kyo-Wook Kim
Journal of the Korean Fracture Society.2011; 24(3): 237. CrossRef

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T-Plate Fixation for Two- and Three-Part Fractures of the Proximal Humerus: Dong Ju Shin, Se Ang Chang, Young Soo Byun, Dae Hee Hwang, Sung Rak Lee, Sang Hee Kim; J Korean Fract Soc 2005;18(4):426-431. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.426

Abstract PDF

PURPOSE
To evaluate the results and complications of treatment using T-plate fixation for two- and three-part fractures of the proximal humerus.
MATERIALS AND METHODS
Between January 1996 and July 2003, thirty-three patients with two-part and three-part fractures of the proximal humerus were treated by T-plate fixation. There were 21 two-part fractures and 12 three-part fractures including three shoulder dislocations. The reduction was qualified and complications were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system.
RESULTS
Thirty-two cases (96.7%) were united, twenty-nine cases (87.9%) were reduced as good, and twenty-three cases (70%) had excellent or satisfactory results. There were four cases of loss of reduction, three cases of stiff joint, one case of nonunion, and one case of avascular necrosis of the humeral head, but no infection. No correlation was found between the final result and the type of fracture, age, gender, or quality of reduction.
CONCLUSION
T-plate fixation for proximal humeral fractures is a reliable method to obtain good results through satisfactory reduction, rigid fixation, and early movement. Additional tension band wiring can provide stable fixation for osteoporotic or comminuted fractures difficult to obtain stable fixation.

Citations

Citations to this article as recorded by

The Surgical Outcomes for Isolated Greater Tuberosity Fracture of Proximal Humerus
Eun-Sun Moon, Myung-Sun Kim, Young-Jin Kim
Journal of the Korean Fracture Society.2007; 20(3): 239. CrossRef

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