Corrective Osteosynthesis in Failed Proximal Humeral Fractures.

Corrective Osteosynthesis in Failed Proximal Humeral Fractures. Z Orthop Unfall. 2019 Oct 21;: Authors: Dey Hazra RO, Lill H, Ellwein A, Warnhoff M, Jensen G Abstract Despite implant improvement and increasing standardisation of operation techniques, the rate of therapy failure of proximal humeral fracture care with primary osteosyntheses is estimated to be 10 to 20%. Most commonly failure is precipitated by: material failure, technical error, non-anatomical repositioning, avascular necrosis, lacking medial support. An additive medial stabilisation of the so-called "calcar region" can decrease failure rates significantly. An early correction osteosynthesis with the purpose of restoring the anatomy is indicated in bony, non-consolidated "fresh" fractures. Bony consolidated fractures should be classified according to Boileau and Walch. The authors of this article advice a structured and classification-adapted approach to treatment with a correction osteosynthesis. Post-traumatic deficits can be augmented utilising the following methods: correction osteosynthesis with allogeneic/autologous bone grafts, correction osteosynthesis with hydroxyapatite grafts. For the additive stabilisation of repositioned and fixated fractures, the following are described: correction osteosynthesis with an additive ventral one-third tubular plate, correction osteosynthesis with cement-augmented screws. Based on results of endoprosthetics following fractures...
Source: Zeitschrift fur Orthopadie und Unfallchirurgie - Category: Orthopaedics Tags: Z Orthop Unfall Source Type: research