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[T-plate osteosynthesis in dislocated proximal humerus fractures]
H Lill1, K Lange, J Prasse-Badde
1Klinik für Unfall- und Wiederherstellungschirurgie, Universität Leipzig.
Unfallchirurgie
|January 31, 1998
Summary
T-plate osteosynthesis can treat dislocated proximal humerus fractures. Poor functional outcomes were linked to fragment displacement and axial deviation, not fracture type or humeral head necrosis.
Area of Science:
- Orthopedic Surgery
- Traumatology
Background:
- Dislocated fractures of the proximal humerus are complex injuries.
- The T-plate offers a surgical option for these fractures.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of T-plate osteosynthesis for dislocated proximal humerus fractures.
- To identify factors correlating with functional outcomes.
Main Methods:
- Retrospective analysis of 48 patients treated with T-plate osteosynthesis between 1988-1995.
- Clinical follow-up using the Constant score and radiological assessment.
- Magnetic Resonance Imaging (MRI) used in 17 patients.
Main Results:
- 33 patients were followed up for a median of 22 months.
- Poor functional results (Constant score) were observed in 15 patients.
- Radiological findings included arthrosis (31%), axial deviation (50%), fragment dislocation (72%), and humeral head necrosis (39%).
- MRI provided valuable information on soft tissues and bone quality, aiding necrosis detection.
Conclusions:
- T-plate osteosynthesis is a viable treatment for dislocated proximal humerus fractures when performed with early intervention, accurate reduction, and adherence to biological principles.
- Fragment displacement and persistent axial deviation significantly impacted functional outcomes more than fracture complexity or humeral head necrosis.