Abstract
We describe the technique of open reduction and fixation of displaced 2 and 3 part proximal humeral fracture, in which, two ‘figure of 8’ heavy braided sutures are passed through drill holes deep to the bicipital groove and passed through the fracture fragments and the cuff in a tension band fashion.
A series of 12 patients, with a mean age of 65 years (range: 44–75 years), were reviewed at an average of 16 months (range: 4–18 months) after fracture fixation. The patients were assessed clinically, and radiographic evaluation of fracture healing, avascular necrosis and malunion was performed. Any complications of treatment were noted.
All fractures united with no evidence of avascular necrosis. There was some varus deformity in two cases. There was one early loss of reduction but stability was re-established at re-exploration. Good or excellent clinical results were obtained in 10 patients according to the Constant score. Active abduction > 120° was achieved in 75% (nine patients).
Paired suture fixation is an effective means of achieving stabilisation after open reduction of displaced two and three part proximal humeral fractures, with a low rate of non-union while preserving a good functional range of motion. The advantages of this technique are the minimal soft tissue stripping and the avoidance of complications associated with metalwork.
The abstracts were prepared by Mr Roger Emery. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN
