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Original Article
Treatment with Modified Steinmann Pins and Tension Band Wiring Technique in Proximal Humeral Comminuted Fractures with Osteoporosis
Soo-Tai Chung, M.D., Joo-Hak Kim, M.D., Hyung-Soo Kim, M.D., Sang-Joon Park, M.D.
Journal of the Korean Fracture Society 2007;20(2):184-189.
DOI: https://doi.org/10.12671/jkfs.2007.20.2.184
Published online: June 14, 2016

Department of Orthopaedic Surgery, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea.

Address reprint requests to: Joo-Hak Kim, M.D. Department of Orthopaedic Surgery, Myongji Hospital, Kwandong University College of Medicine, 697-24, Hwajeong-dong, Deogyang-gu, Goyang 412-270, Korea. Tel: 82-31-810-5409, Fax: 82-31-810-6537, hand0123@kwandong.ac.kr

Copyright © The Korean Fracture Society. All rights reserved

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  • Purpose
    To evaluate the usefulness of internal fixation with modified Steinmann pins and tension band wiring technique in comminuted proximal humeral fracture with osteoporosis and the correlations among bone mineral density, age, Neer's score and period of union.
  • Materials and Methods
    Twelve cases of comminuted proximal humeral fracture with osteoporosis were surgically treated with modified Steinmann pins and tension band technique, and followed up for an average 20.8 months (range, 6~39 months). Average age was 73.6 years old (range, 59~85 years old). Results were assessed using Neer's evaluation criteria.
  • Results
    Excellent results were noted in eight cases and satisfactory results in four cases. Radiological union was obtained in all cases. Two cases showed impingement syndrome of the proximal portions of Steinmann pins, which were managed by early removal of the metal. One case developed operative wound infection, which were managed by antibiotics therapy, irrigation and secondary closure.
  • Conclusion
    Internal fixation using modified Steinmann pins and tension band wiring technique for proximal humeral fracture, with osteoporosis, makes complete union of fracture, minimizes risk of complications, and enables early rehabilitation by rendering relatively rigid fixation.
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Fig. 1

(A) Modified steinmann pins have different sizes. (B) Modified steinmann pin has proximal two holes.

jkfs-20-184-g001.jpg
Fig. 2

(A) Initial radiograph shows a surgical neck fracture of the proximal humerus, eighty five-year-old woman. (B) Postoperative radiograph shows intramedullary fixation with two modified Steinmann pins and one tension band wiring.

jkfs-20-184-g002.jpg
Fig. 3

(A) Initial radiograph shows a 3 part fracture of the proximal humerus sixty eight-year-old woman. (B) Postoperative radiograph shows intramedullary fixation with two modified Steinmann pins and two tension band wirings.

jkfs-20-184-g003.jpg
Fig. 4

This graph shows a correlation between age and average of Neer's score.

jkfs-20-184-g004.jpg
Fig. 5

This graph shows a correlation between age and average of union period.

jkfs-20-184-g005.jpg
Fig. 6

This graph shows a correlation between BMD and average of union period.

jkfs-20-184-g006.jpg
Table 1

Patient data

jkfs-20-184-i001.jpg

*Neer's classification. T. A: Traffic accident, Fx: Fracture, F/U: Follow up, Mon: Months, Wks: Weeks.

Table 2

Results according to Neer's evaluation criteria

jkfs-20-184-i002.jpg

S: Satisfactory, E: Excellent. *3 part fracture.

Figure & Data

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        Treatment with Modified Steinmann Pins and Tension Band Wiring Technique in Proximal Humeral Comminuted Fractures with Osteoporosis
        J Korean Fract Soc. 2007;20(2):184-189.   Published online April 30, 2007
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      We recommend
      Treatment with Modified Steinmann Pins and Tension Band Wiring Technique in Proximal Humeral Comminuted Fractures with Osteoporosis
      Image Image Image Image Image Image
      Fig. 1 (A) Modified steinmann pins have different sizes. (B) Modified steinmann pin has proximal two holes.
      Fig. 2 (A) Initial radiograph shows a surgical neck fracture of the proximal humerus, eighty five-year-old woman. (B) Postoperative radiograph shows intramedullary fixation with two modified Steinmann pins and one tension band wiring.
      Fig. 3 (A) Initial radiograph shows a 3 part fracture of the proximal humerus sixty eight-year-old woman. (B) Postoperative radiograph shows intramedullary fixation with two modified Steinmann pins and two tension band wirings.
      Fig. 4 This graph shows a correlation between age and average of Neer's score.
      Fig. 5 This graph shows a correlation between age and average of union period.
      Fig. 6 This graph shows a correlation between BMD and average of union period.
      Treatment with Modified Steinmann Pins and Tension Band Wiring Technique in Proximal Humeral Comminuted Fractures with Osteoporosis

      Patient data

      *Neer's classification. T. A: Traffic accident, Fx: Fracture, F/U: Follow up, Mon: Months, Wks: Weeks.

      Results according to Neer's evaluation criteria

      S: Satisfactory, E: Excellent. *3 part fracture.

      Table 1 Patient data

      *Neer's classification. T. A: Traffic accident, Fx: Fracture, F/U: Follow up, Mon: Months, Wks: Weeks.

      Table 2 Results according to Neer's evaluation criteria

      S: Satisfactory, E: Excellent. *3 part fracture.


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