Minimally invasive percutaneous plate osteosynthesis for the treatment of proximal humerus fractures in osteoporotic patients with Philos plate

Ram Ji Lal Sahu

doi:10.3329/bjms.v12i2.14941

Abstract

Introduction: To investigate the effect of minimally invasive percutaneous plate osteosynthesis for treatment of proximal humerus fractures in osteoporotic patients with philos plate. Methods: A prospective study was conducted at Department of Orthopedics, M.M.Medical College, Mullana Ambala, from July 2005 to November 2010. A Total of 108 cases of proximal humerus fractures were treated with minimally invasive percutaneous plate osteosynthesis with philos plate. According to Neer classification, 89 cases had two part fractures, 19 had tree part fractures. Results: All the 108 cases were followed up ranging from 12 to 18 months with an average of 14 months. Radio graphically, union was observed in 92 patients at the end of 10 weeks. In 10 patients, times to union were 16 weeks. Six patients underwent autogenous bone grafting because of nonunion after 16 weeks. The mean Constant-Murley score was 86 (range 74-92). The functional results of the shoulder, according to Muley scores, were classified as excellent in 85.15% cases, good in 9.25% cases and fair in 5.55 cases. Conclusion: Minimally invasive percutaneous plate osteosynthesis for treatment of proximal humerus fractures in osteoporotic patients with philos plate shows good results and less complication. Bangladesh Journal of Medical Science Vol. 12 No. 02 April13 Page 140-145 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14941

Highlights

To investigate the effect of minimally invasive percutaneous plate osteosynthesis for treatment of proximal humerus fractures in osteoporotic patients with philos plate
Conventional plate osteosynthesis has been associated with high complication rates due to loss of fixation, screw pull out, and collapse of the head fragments[5,6,7,8]
The proximal humeral locking plate with angular stable locking head screws that enter the humeral head at various angles appears to provide satisfactory purchase in osteoporotic bone

Summary

Introduction

To investigate the effect of minimally invasive percutaneous plate osteosynthesis for treatment of proximal humerus fractures in osteoporotic patients with philos plate. A Total of 108 cases of proximal humerus fractures were treated with minimally invasive percutaneous plate osteosynthesis with philos plate. Conclusion: Minimally invasive percutaneous plate osteosynthesis for treatment of proximal humerus fractures in osteoporotic patients with philos plate shows good results and less complication. Tension band wiring provides better stability but often requires valgus impaction of the head fragment This may results in shortening, with laxity of the deltoid muscle and subsequent subluxation of the shoulder joints. The aim of this study was to evaluate the clinical outcome and complications of Minimally invasive percutaneous plate osteosynthesis for treatment of proximal humerus fractures in osteoporotic patients with Philos plate

Objectives

Methods

Findings

Conclusion