Da Vinci System: clinical experience with complex proximal humerus fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomaterials Engineering

Background:

• Proximal humerus fractures present significant challenges in reconstruction and achieving stability.
• Traditional methods may struggle with metaphyseal bone loss and revascularization.
• The Da Vinci System evolved from previous bone block techniques.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of open reduction and internal fixation for displaced proximal humerus fractures using the Da Vinci System.
• To assess the efficacy of this innovative titanium cage in managing complex fracture patterns.

Main Methods:

• Open reduction and internal fixation using the Da Vinci System (titanium cage).
• Fracture fragments reduced onto the cage and stabilized with Kirschner wires, screws, or sutures.
• Follow-up included clinical assessment (Constant score) and radiographic evaluation.
• Study included 59 patients with a minimum 12-month follow-up.

Main Results:

• Mean Constant score of 80.25 at a mean follow-up of 24 months.
• Excellent or good results in 48 out of 59 cases.
• Mean active anterior elevation of 160 degrees.
• High healing rate with only one case of deep infection.

Conclusions:

• The Da Vinci System is an effective innovation for treating complex proximal humerus fractures.
• It facilitates fragment reconstruction, stability, and addresses metaphyseal bone loss.
• The system offers favorable clinical outcomes and a high union rate.