Objectives. The goal of this study is to investigate the relation between indicators of osteoporosis (i.e., bone mineral density (BMD), and Cortical Index (CI)) and the complexity of a fracture of the
Abstract. Reverse shoulder arthroplasty (RSA) is being increasingly used for complex, displaced fractures of the
We reviewed the results of sixteen patients with three and four part proximal humerus fractures treated with the Locking
Abstract. Background. Fractures
The morphology of the proximal part of the humerus varies largely. Morphometric features characterizing the three-dimensional geometry of the
The
Introduction: The treatment of fractures of the
Aim. The aim of this study was to analyze our results using a modular endoprosthetic replacement system (MUTARS) for bone tumours of the
Although new locking plates allows for secure fixation of osteoporotic fractures in the
Introduction: Locking plates and screws have been developed to increase stability of internal fixation in osteoporotic bone. The anatomic design should also facilitate the fracture’s reduction in complex cases. The aim of this study was analyse the results of locking plates used for fractures of the
Introduction: The treatment of fractures of the
Title. 3D distribution of cortical bone thickness in the
Fractures of the
Objectives. The objective of this study was to perform a meta-analysis of all randomised controlled trials (RCTs) comparing surgical and non-surgical management of fractures of the
Introduction: Management of displaced comminuted fractures of the
Purpose: Primary bone tumours located in the upper limb are mainly found in the proximal portion of the humerus. Tumour resection raises difficult situations due to the sacrifice of the cuff tendons. We propose a decision making scheme for determining the best reconstruction strategy. Material and methods: This retrospective analysis was based on 35 cases (19 massive prostheses, ten composite prostheses, three inverted prostheses and three composite arthrodeses). All the clinical and radiographic data were reviewed to examine function, active motion, pain, and use of the upper limb in everyday activities. Results: Massive humeral prostheses provided a technically simple solution but produced mediocre functional results: painless shoulder without active motion, but preservation of elbow and forearm function. Composite humeral prostheses (prosthesis + allograft) did not, in our experience provide any gain in function compared with massive prostheses. Allografts were resorbed after four to five years. Composite arthrodesis with allograft and vascularised fibular graft provided a mobile shoulder with a useful amplitude and a pain free joint. Results persisted. The inverted Delta prostheses (Grammont) covered with allografts and with preservation of the rotator cuff tendons offered an interesting alternative with functional results superior to arthrodesis and similar to those with shoulder prostheses implanted for degenerative disease. The persistence of the glenoid anchorage remains uncertain. Conclusions: We use the following scheme for reconstruction of the
The aim of the study was to assess the medium term outcome for complex proximal humeral fractures treated with the long proximal humeral internal locking system (PHILOS) plate fixation. All patients who had long PHILOS plate fixation of proximal humerus fractures with metaphyseal or diaphyseal extension over a three year period at our institution were included in the study. Patients had their case notes and radiographs reviewed. Patients were also contacted to assess functional outcome using the Visual Analogue Scale (VAS) for pain, DASH, Oxford shoulder score (OSS) and Stanmore Percentage of Normal Shoulder Assessment (SPONSA). Out of an initial cohort of 34 patients, 1 died, 2 patients had unrelated illnesses resulting in them being unable to complete the assessment and 6 were lost to follow-up, leaving 25 patients (74%) for review. All patients had proximal humeral fractures with metaphyseal or diaphyseal extension requiring long plate osteosynthesis. One patient had the procedure for non union following initial treatment with an intra medullary nail and the rest were acute injuries. The patients were followed up after a mean of 27 months (range 11–60). The length of plate used varied from 5 to 12 holes for the shaft region. There was 1 wound infection. 3 patients had non unions which required bone grafting and revision internal fixation. At final follow-up, mean pain was 3.6 (95% Confidence Interval 2.5–4.8) with only 4 patients having residual pain greater than 5 on the VAS scale. Mean DASH score was 41.2 (95% CI 32.0–50.4), mean OSS was 29.1 (95% CI 24.3–33.9) and mean SPONSA was 63.9% (95% CI 50.8–77.2) The long PHILOS plate appears to represent a good treatment option for complex proximal humerus fractures with favourable medium term results and few complications.
Introduction and Objectives: This study analyses the results of our experience in reconstruction of high-grade sarcomas of the
Introduction. Proximal humeral fracture occurs most frequently in elderly and usually unite within 12 weeks. Malunion is more common than nonunion. And even if nonunion occurs, we usually treat it by the blade plate. Norris et al. reported hemiarthroplasty is indicated for severe degenerative changes of the articular surface, osteonecrosis of the humeral head, or osteopenia severe enough to jeopardize fixation in order patients. Therefore, it is not common that hemiarthroplasty is used for primary treatment of the proximal humeral pseudoarthrosis. We report a case of
Reconstruction of the shoulder joint following resection of the