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Date Published: 03/11/2023
Online Published: 20/11/2023
Abstract Views: 134
Views PDF: 111
DOI: https://doi.org/10.58490/ctump.2023i68.2252
Issue
No. 68 (2023)
Section
Article
How to Cite
Le, G. A. T., Dinh, N. M., Nguyen, T. T., Nguyen, M. L., Pham, T. T., & Nguyen, N. T. T. (2023). EVALUATE THE ROLE OF THE CALCAR SCREWS IN OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING PLATE FOR THE TREATMENT OF THE PROXIMAL HUMERAL FRACTURES. Cantho Journal of Medicine and Pharmacy, 68, 89-96. https://doi.org/10.58490/ctump.2023i68.2252

EVALUATE THE ROLE OF THE CALCAR SCREWS IN OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING PLATE FOR THE TREATMENT OF THE PROXIMAL HUMERAL FRACTURES

Gia Anh Thy Le1, Ngoc Minh Dinh1,, Tan Toan Nguyen1, Minh Loc Nguyen1, Thanh Tan Pham1, Ngoc Thanh Tam Nguyen1
1 Hospital for Traumatology and Orthopaedics

Main Article Content

Abstract

Background: Fractures of the proximal humerus account for a high proportion of all fractures. The incidence and complexity of these fractures increases with patient age. Restoring the stability of the medial hinge while doing the osteosynthesis is of great interest to many surgeons. Objectives: To evaluate and compare the treatment results as well as the rate of complications: secondary displacement, humeral head necrosis of internal fixation using locking plate to treat proximal humerus fractures in two group with calcar (group N+) and without calcar screws (group N-). Materials and Methods: A retrospective clinical study described 125 patients had been done the internal fixation with locking plate at Hospital for Traumatology and Orthopaedics, Ho Chi Minh city from 2018 – 2021, of which 69 cases had calcar screws, 56 cases was without calcar screws. Assessment of functional recovery was based on the Constant-Murley scale, the secondary displacement was based on monitoring the distance form the proximal end of the plate to the tip of the humeral head, and the humeral head necrosis was based on the Cruess classification system. Results: Group N+ had a better level of functional recovery and lower level of secondary displacement than group N- with P = 0.03 and 0.01, respectively. The rate of humeral head necrosis in group N+ was 15.93% and 14.27 % in the group N- group with P = 1. Conclusion: The placement of calcar screws in the locking plate fixation of proximal humeral fractures is associated with better shoulder function recovery and maintenance of reduction.

Article Details

Keywords

Proximal humeral fracture, calcar screws, humeral head necrosis

References

1. Agudelo, J., et al., Analysis of efficacy and failure in proximal humerus fractures treated with locking plates. J Orthop Trauma, 2007. 21(10): 676-81, doi: 10.1097/BOT.0b013e31815bb09d.
2. Nguyễn Minh Lộc, Điều trị gãy đầu trên xương cánh tay ở người lớn bằng nẹp khoá. 2014, Trường Đại học Y Khoa Phạm Ngọc Thạch.
3. Perez, E.A., Fractures Around The Shoulder, in Campbell’s Operative Orthopaedics, F.M. Azar and J.H. Beaty, Editors. 2021, Elsevier. 3040-3058.
4. Hertel, R., et al., Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg, 2004. 13(4): 427-33, doi: 10.1016/j.jse.2004.01.034.
5. Gardner, M.J., et al., The importance of medial support in locked plating of proximal humerus fractures. J Orthop Trauma, 2007. 21(3): 185-91, doi: 10.1097/BOT.0b013e3180333094.
6. Osterhoff, G., et al., The calcar screw in angular stable plate fixation of proximal humeral fractures--a case study. J Orthop Surg Res, 2011. 6: 50, doi: 10.1186/1749-799X-6-50.
7. Lin, S.J., et al., Medial calcar support and radiographic outcomes of plate fixation for proximal humeral fractures. Biomed Res Int, 2015. 2015: 170283, doi: 10.1155/2015/170283.
8. Neer, C.S., 2nd, Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am, 1970. 52(6): 1077-89.
9. Esser, R.D., Treatment of three- and four-part fractures of the proximal humerus with a modified cloverleaf plate. J Orthop Trauma, 1994. 8(1): 15-22, doi: 10.1097/00005131-199402000-00005. 10. Court-Brown, C.M., et al., Fractures in older adults. A view of the future? Injury, 2018. 49(12): 2161-2166, doi: 10.1016/j.injury.2018.11.009.
11. Kristiansen, B., et al., Epidemiology of proximal humeral fractures. Acta Orthop Scand, 58(1): 75-7.
12. Brunner, F., et al., Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma, 2009. 23(3): 163-72, doi: 10.1097/BOT.0b013e3181920e5b.
13. Ong, C.C., et al., Outcomes of open reduction and internal fixation of proximal humerus fractures managed with locking plates. Am J Orthop (Belle Mead NJ), 2012. 41(9): 407-12.
14. Zhang, L., et al., The clinical benefit of medial support screws in locking plating of proximal humerus fractures: a prospective randomized study. Int Orthop, 2011. 35(11): 1655-61, doi:
10.1007/s00264-011-1227-5.
15. Hung, C.Y., et al., The effect of medial calcar support on proximal humeral fractures treated with locking plates. J Orthop Surg Res, 2022. 17(1): 467, doi: 10.1186/s13018-022-03337-5.
16. Oppebøen, S., et al., Calcar screws and adequate reduction reduced the risk of fixation failure in proximal humeral fractures treated with a locking plate: 190 patients followed for a mean of 3 years. J Orthop Surg Res, 2018. 13(1): 197, doi: 10.1186/s13018-018-0906-y.