Intramedullary Fixation for Proximal Humeral Fractures.

Intramedullary Fixation for Proximal Humeral Fractures. J Am Acad Orthop Surg. 2019 Dec 17;: Authors: Sears BW, Hatzidakis AM, Johnston PS Abstract Proximal humeral fractures are a commonly encountered injury; however, no consensus has been reached for the ideal treatment. Current surgical fixation options include plate, plate with fibular strut allograft, intramedullary fixation, pinning, suture constructs, and external fixation. Each of these options possesses distinct advantages and disadvantages. With the evolution of implant design, a greater understanding of the mechanisms of failure of fixation, and the ability to preserve fracture biology, the management of proximal humeral fractures with intramedullary fixation has become an accepted treatment option. From a biomechanical perspective, intramedullary fixation may have advantages over laterally based fixation, in particular with fractures associated with significant calcar comminution. The ability to insert the implant from a superior starting point may help preserve vascular supply to the humeral head and tuberosities. With reported outcomes comparable with the aforementioned techniques and an evolving understanding of fracture characteristics and failures of fixation, intramedullary fixation represents an alternative treatment option for proximal humeral fractures with specific fixation and biologic advantages. PMID: 31860585 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research