Izvorni znanstveni članak
THE RESULTS OF INTERNAL FIXATION OF PROXIMAL HUMERAL OSTEOPOROTIC FRACTURES WITH PHILOS LOCKING PLATE
Ante Bandalović
; University Hospital Split, Department of Traumatology, Split, Croatia
Fabijan Čukelj
; University Hospital Split, Department of Traumatology, Split, Croatia
Josip Knežević
; University Hospital Split, Department of Traumatology, Split, Croatia
Marko Ostojić
; University of Mostar, School of Medicine, University Hospital Mostar, Department of Orthopaedics and Traumatology, Mostar, Bosnia and Herzegovina
Arsen Pavić
; University Hospital Split, Department of Traumatology, Split, Croatia
Zlatko Parać
; University Hospital Split, Department of Traumatology, Split, Croatia
Matko Rošin
; University Hospital Split, Department of Traumatology, Split, Croatia
Sažetak
Background: In the last fifty years since plate and screw osteosynthesis has been implemented in fracture treatment,
osteosporotic bone fractures were observed as a special problem. Due to special histologic, anatomic, physical and biomehanic
properties of osteoporotic changed bone the laws of biomechanics suggest that stable osteosynthesis for osteoporotic bone is
necessary to increase the contact surface of metallic implants and bone and the stability of the screw-plate-bone compound. There
are numerous surgical techniques and methods for treatment of osteoporotic proximal humeral fractures. Every surgical procedure
has to establish anatomical reduction and stable fixation that will enable early mobilisation.
Subjects and methods: The aim of this study was to present results of internal fixation of proximal humeral osteoporotic
fractures with PHILOS locking plate. Between 2007 and 2012, a total of 67 patients older than 65 years with closed proximal
humerus fractures underwent surgical treatment with PHILOS plate system (Synthes, Switzerland). 42 patients were operated with
deltopectoral approach and 25 with deltoid split approach. After a mean follow up period of 14.68 (6-28) months functional and
radiologic results were assessed.
Results: We noted 9 postoperative complications related to surgical technique (1 intraarticular screw placement, 1 displacement
in major tuberculum fragment, 1 displacement in major tuberculum fragment along with oblique placement of the plate, 2 cases of
inadequate reduction, 1 case of humeral head avascular necrosis, varus humeral head fixation in 3 cases). None of the patients
developed superficial or deep surgical infection. There was no nonunions. In the final evaluation, the Constant shoulder score was
91.75 (72-100).
Conclusions: In this study PHILOS locking plate showed good applicability, respecting bone biologic properties because of
negligible interference with blood supply of the humeral head. There was no requirement to shape the plate enabling stabilization at
constant angles as clear benefit of this plate. All that enables early mobilisation, and no implant insufficiency resulting in
satisfactory treatment results and high Constant shoulder scores.
Ključne riječi
proximal humerus fracture; osteoporotic fracture; locking compression plate; PHILOS; deltopectoral approach; deltoid split approach
Hrčak ID:
265247
URI
Datum izdavanja:
5.11.2014.
Posjeta: 308 *