Treatment of Proximal Humeral Fractures by
Angular Stabile, Antegrade, Interlocking Intramedullar Nail
Višňa P., Beitl E., Jaganjac E., Kalvach J., Šmídl Z.
Traumatologické oddělení, Chirurgická klinika UK 2. LF a FN Motol, Praha, přednosta: prof. MUDr. J. Hoch, CSc. |
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Summary:
Introduction: The objective of our study is evaluation of clinical and radiological results of dislocated proximal humeral fractures, treated
by direct, angular stabile, antegrade and interlocking implants Targon PH (Aesculap, Tuttlingen, Germany).
Methods: We evaluated 102 patients (76 female and 26 male), average age was 67.3 years (26–87 years). The standard nail was used
in 73 cases; the long one was used in 29 cases. We interpreted functional results (Constant’s score and relative Constant’s score), radiological
results and postoperative complications.
Results: Constant’s score achieved average 51.3 points – 3 weeks after operation, 67.4 points – after 6 months and 75.8 points – after
1 year. Value of the relative Constant’s score was 59.3%, 75.9% and 83.5%. We have found trend to the poorer functional outcomes in all
complicated four-part fractures; especially in cases with disarticulation.
The complete bone healing was reached in: 63.7% up to 3 months, 95.1% up to 6 months and 99 % up to 1 year. We detected 1case of
the pseudoarthrosis.
We had 37 complications in our 102 patients group in the first year after operation. The migration of the proximal fixation screws was
most frequent complication – 12 patients. Eight times the humeral head aseptic necrosis appeared (5x partial, 3x complete), 3 times redislocation
of tuberculum maius was found. We made reoperation 2 times by Phillos plate (1x for pseudoarthrosis, 1x for broken screws).
Conclusions: Targon PH is intramedullary nail stabilisation of proximal humeral fractures by angular stabile, antegrade, interlocking
system. We consider it for mini-invasive technique that provides high stability in osteoporotic bone and allows immediate postoperative
shoulder mobilisation.
Key words:
antegrade intramedulary nail – fractures of proximal humerus
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