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.
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: J L Marsh; Theddy F Slongo; Julie Agel; J Scott Broderick; William Creevey; Thomas A DeCoster; Laura Prokuski; Michael S Sirkin; Bruce Ziran; Brad Henley; Laurent Audigé Journal: J Orthop Trauma Date: 2007 Nov-Dec Impact factor: 2.512
Authors: Ioannis S Benetos; Panayiotis K Karampinas; Andreas F Mavrogenis; Pavlos Romoudis; Spiros G Pneumaticos; John Vlamis Journal: Orthopedics Date: 2012-12 Impact factor: 1.390