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Erschienen in: Archives of Orthopaedic and Trauma Surgery 9/2009

01.09.2009 | Trauma Surgery

Internal fixation of proximal humerus fractures using the T2-proximal humeral nail

verfasst von: Dragos Popescu, Jenaro A. Fernandez-Valencia, Moisés Rios, Jordi Cuñé, Anna Domingo, Salvi Prat

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 9/2009

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Abstract

Introduction

Surgical management of proximal humerus fractures remains controversial and there is an increasing interest in intramedullary nailing. Created to improve previous designs, the T2-proximal humeral nail (PHN) (Stryker®) has been recently released, and the English literature lacks a series evaluating its results. We present a clinical prospective study evaluating this implant for proximal humeral fractures.

Method

We evaluated the functional and radiological results and possible complications. Twenty-nine patients with displaced fractures of the proximal humerus were treated with this nail. One patient was lost right after surgery and excluded from the assessment. Eighteen patients were older than 70 years.

Results

There were 21 fractures of the proximal part of the humerus and 7 fractures that also involved the shaft; 15 of the fractures were two-part fractures (surgical neck), 5 were three-part fractures, and 1 was a four-part fracture. All fractures healed in a mean period of 2.7 months. There was one delayed union that healed in 4 months. One case of avascular necrosis of the humeral head was observed (a four-part fracture), but remained asymptomatic and did not require further treatment. In one case a back-out of one proximal screw was observed. A final evaluation with a minimum 1 year follow-up was performed by an independent observer; in 18 patients, the mean Constant score was 65.7 or 76.1% with the adjustment of age and gender; in 19 patients, the mean Oxford Shoulder Score was 21.7. The results obtained with the T2-PHN nail indicate that it represents a safe and reliable method in the treatment of two- and three-part fractures of the proximal humerus. The proximal fixation mechanism diminishes the rate of back-out of the screws, a frequent complication described in the literature. Better functional results were obtained from the patients younger than 70 years, but these were not statistically significant.
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Metadaten
Titel
Internal fixation of proximal humerus fractures using the T2-proximal humeral nail
verfasst von
Dragos Popescu
Jenaro A. Fernandez-Valencia
Moisés Rios
Jordi Cuñé
Anna Domingo
Salvi Prat
Publikationsdatum
01.09.2009
Verlag
Springer-Verlag
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 9/2009
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-008-0789-1

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