Publication: Treatment of unusual proximal humeral fractures using unilateral external fixator: a case series
Objective To report the functional and radiological results of unusual comminuted fractures of the proximal humerus, treated with ‘closed reduction and external fixation’ (CREF) using hybrid-type unilateral external fixators (EFs). Patients and methods Between January 2012 and June 2013, eight patients (mean age 62.6; range 48–84 years) with comminuted proximal humeral fractures extending to the humeral head and one-third proximal diaphysis were treated with CREF using hybrid-type EFs. Functional results were evaluated in terms of shoulder ranges of movement, Constant, DASH, and VAS scores, and radiological results were evaluated using antero-posterior and lateral radiograms of the treated humerus. Results The mean follow-up was 16.6 (range 12–28) months. The mean fixator time was 84 (range 63–118) days. The mean range of forward flexion, internal rotation, external rotation, and abduction were 145°, 61.2°, 65°, and 115°, respectively. The mean Constant, DASH, and VAS scores were 79.8, 10, and 1.75, respectively. Seven of the eight patients (87.5 %) healed radiologically. Two complications were observed in two patients: non-union and superficial pin site infection. Conclusions In the treatment of unusual, comminuted proximal diaphyseal humeral fractures, CREF using a hybrid-type EF is a minimally invasive, advantageous procedure with acceptable rates of healing, low risk of surgical site infection, and early range of motion. Level of evidence Level IV, case series.
Proximal Humeral Fractures
UZER G., YILDIZ F., Elmadağ M., Bilsel K., PULATKAN A., -Treatment of unusual proximal humeral fractures using unilateral external fixator: a case series-, European Journal of Orthopaedic Surgery and Traumatology, cilt.25, ss.683-687, 2015