Yaniv Bismuth1, Adeline Cambon-Binder1, Alain Sautet1, Levon Doursounian1, Thomas Gregory2, Claire Bastard3. 1. Département de chirurgie orthopédique et traumatologie, Hopital Saint Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France. 2. Département de chirurgie orthopédique et traumatologie, Hopital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France. 3. Département de chirurgie orthopédique et traumatologie, Hopital Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France. claire.bastard@hotmail.fr.
Abstract
PURPOSE: Surgical treatment of three or four part fractures of the proximal humerus is complex. Different conservative techniques have been described. The main goal of this study was to compare the clinical and radiological outcomes of Bilboquet and locking plate at two year follow-up. METHODS: This is a retrospective, comparative study, with a continuous series of 41 patients. Bony fixation was achieved with a Bilboquet device in 22 patients or a locking plate in 19 patients. Patient evaluation included clinical data: shoulder range of motion, Constant-Murley shoulder score and DASH (Disabilities of the Arm, Shoulder and Hand) score, and imaging using standard shoulder X-rays. RESULTS: Of the 41 patients included, 1 patient was lost to follow-up in the locking plate group. At a mean follow-up of 24 months patients in Bilboquet group showed a Constant score higher than in locking plate (p = 0.02). Range of motion and DASH score were not significantly different between the two groups. avascular necrosis occured in three patients of Bilboquet group (14%) versus in two patients in the locking plate group (11%) (p > 0.5). Complication and reintervention rate were non-significantly higher in the locking plate group than in the Bilboquet group (37 vs 14%). CONCLUSION: Bilboquet and locking plate give good functional outcomes in complex proximal humerus fractures. However, the Bilboquet device appears to provide better functional results than locking plate at mid-term follow-up.
PURPOSE: Surgical treatment of three or four part fractures of the proximal humerus is complex. Different conservative techniques have been described. The main goal of this study was to compare the clinical and radiological outcomes of Bilboquet and locking plate at two year follow-up. METHODS: This is a retrospective, comparative study, with a continuous series of 41 patients. Bony fixation was achieved with a Bilboquet device in 22 patients or a locking plate in 19 patients. Patient evaluation included clinical data: shoulder range of motion, Constant-Murley shoulder score and DASH (Disabilities of the Arm, Shoulder and Hand) score, and imaging using standard shoulder X-rays. RESULTS: Of the 41 patients included, 1 patient was lost to follow-up in the locking plate group. At a mean follow-up of 24 months patients in Bilboquet group showed a Constant score higher than in locking plate (p = 0.02). Range of motion and DASH score were not significantly different between the two groups. avascular necrosis occured in three patients of Bilboquet group (14%) versus in two patients in the locking plate group (11%) (p > 0.5). Complication and reintervention rate were non-significantly higher in the locking plate group than in the Bilboquet group (37 vs 14%). CONCLUSION: Bilboquet and locking plate give good functional outcomes in complex proximal humerus fractures. However, the Bilboquet device appears to provide better functional results than locking plate at mid-term follow-up.
Authors: Felix Brunner; Christoph Sommer; Christian Bahrs; Rainer Heuwinkel; Christian Hafner; Paavo Rillmann; Georges Kohut; Anders Ekelund; Mathias Muller; Laurent Audigé; Reto Babst Journal: J Orthop Trauma Date: 2009-03 Impact factor: 2.512
Authors: Levon Doursounian; Anthony Le Sant; Raphael Mauprivez; Anne Miquel; Violaine Beauthier-Landauer Journal: Int Orthop Date: 2016-01-21 Impact factor: 3.075
Authors: N Südkamp; J Bayer; P Hepp; C Voigt; H Oestern; M Kääb; C Luo; M Plecko; K Wendt; W Köstler; G Konrad Journal: J Bone Joint Surg Am Date: 2009-06 Impact factor: 5.284