Proximal humeral shaft fractures are rare injury. In such case, to the best of our knowledge, the treatment by both double-plate method and the MIPO has never been seen before in the literature. Here we report our experience and management about this method. A 69-year-old man who suffered falling down at home to his right shoulder that resulted in co-existing fractures of the proximal humerus and humeral shaft. According to AO/ASIF classification, he had 11-B1 and 12-A1 fractures ipsilaterally. He was treated by double plate method with PHILOS (SYNTHES, Japan) to proximal humerus and narrow LC-LCP(SYNTHES, Japan) to humeral shaft. Intraoperatively we put the skin incision about 3.0 cm each in three places, for reduction and fixation by the MIPO. Postoperatively, external fixation was only sling and physiotherapy was initiated after third post-operative days for range of motion exercises.Introduction
Materials & Methods
The treatment of large segmental defects of long bones, which is caused by high energy trauma, revision surgery and resection of tumor or osteomyelitis and so on, is usually difficult. Recently the usefulness of Induced membrane technique (Masquelet technique) is reported. Induced membrane technique is an alternative method to reconstruct long-bone defects, which is two-stage surgery and combines the use of induced pseudo-membranes and cancellous autografts. The mechanism of bone formation in this technique is unknown. We performed Induced membrane technique on four patients, collected their membranes, and tested osteogenic ability and multipotency of cells derived from the membrane. From 2011, we had 4 patients of large segmental defects of long bones, which underwent operations of induced membrane technique. All operation performed by one surgeon. There were 2 nonunion (2 femur) and 1 open fracture (tibia), and close comminuted fracture (femur). Average length of bone defects was 5 cm. On the second stage, we collect some membranes and cultured cells derived from them. Then, cultured cells were tested for the ability to differentiate in vitro to multiple lineage.Introduction
Material and Method
