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MUSCULOSKELETAL SURGERY
Published in: MUSCULOSKELETAL SURGERY 1/2017

01-04-2017 | Original Article

A prospective study for the treatment of proximal humeral fractures with the Galaxy Fixation System

Authors: R. D’Ambrosi, F. Palumbo, A. Barbato, R. M. Facchini

Published in: MUSCULOSKELETAL SURGERY | Issue 1/2017

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Abstract

Background

Fractures of the proximal humerus represent a common problem in clinical practice; in particular for three- or four-part fractures, there is no consensus regarding which is the best treatment. The aim of our study was to report clinical and radiological outcomes in patients treated with the Galaxy Fixation System™ for a proximal humerus fracture.

Materials and methods

Thirty-two patients of which 18 (56.25%) women, and 14 (43.75%) men suffering from proximal humerus fractures were treated using the Galaxy Fixation System™. Fractures were classified according to Neer and only patients with a three- or four-part fracture with two-thirds of the methaphysis intact were included. Clinical examination included the Constant-Murley score, UCLA score and Quick DASH evaluated at 6, 12 and 24 months after surgery. In addition, at the final follow-up, patients were asked to complete the SF-12 questionnaire. The humeral head-shaft angle was evaluated by radiographs the day after surgery, as well as after 12 and 24 months.

Results

All 32 patients were available for the 6th, 12th and 24th month follow-up examination. The mean interval between trauma and surgery was 2.7 days (range 0–6 days). The period of hospital stay ranged from 2 to 8 days with an average of three days. The time of healing ranged from 4 to 10 weeks with an average of 7 weeks. The mean Constant score increased from 72.9 after 6 months to a mean of 82.8 at 12 months (p < 0.05) to 88.9 at 24 months (p < 0.05). UCLA score ranged from 27.5 at 6 months to 29.5 at 12 months (p < 0.05) and finally improved to 32.3 at final follow-up (p < 0.05). Quick DASH varied from 7.2 at 6 months after surgery to 5.2 at 12 months after surgery (p > 0.05) and reached the value of 3.1 after 24 months (p > 0.05). Mean Mental Component (MCS) resulted in a value of 48.1, while the Physical Component (PCS) was 52.7. The mean head-shaft angulation was 137.6° the day after surgery compared with 137.5° (p > 0.05) measured 12 months later, and 137.2° measured 24 months later (p > 0.05).

Conclusions

Galaxy Fixation System™ is a safe and efficient procedure for the treatment of three- or four-part proximal humerus fractures, providing an excellent outcome.

Level of evidence

Prospective case series, Level IV.
Literature
1.
Baron JA, Barrett JA, Karagas MR (1996) The epidemiology of peripheral fractures. Bone 18:209S–213SCrossRefPubMed
2.
3.
Lind T, Krøner K, Jensen J (1989) The epidemiology of fractures of the proximal humerus. Arch Orthop Trauma Surg 108:285–287CrossRefPubMed
4.
Roux A, Decroocq L, El Batti S, Bonnevialle N, Moineau G, Trojani C, Boileau P, de Peretti F (2012) Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol Surg Res 98:715–719CrossRefPubMed
5.
Anchuela-Ocaña M, Gómez-García M, Medina-Herráez E, Riquelme-Arias G, Pérez Martín A (1997) Fracturas proximales del húmero. Revisión de las alternativas terapéuticas. Rev Ortop Traumatol 41:205–212
6.
Neer CS 2nd (1970) Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am 52:1077–1089CrossRefPubMed
7.
Kralinger F, Schwaiger R, Wambacher M, Farrell E, Menth-Chiari W, Lajtai G, Hubner C, Resch H (2004) Outcome after primary hemiarthroplasty for fracture of the head of the humerus. A retrospective multicentre study of 167 patients. J Bone Joint Surg (Br) 86:217–219CrossRef
8.
Herscovici D, Saunders DT, Johnson MP, Sanders R, DiPasquale T (2000) Percutaneous fixation of proximal humeral fractures. Clin Orthop 375:97–104CrossRef
9.
Cornell CN, Levine D, Pagnani MJ (1994) Internal fixation of proximal humerus fractures using the screw-tension band technique. J Orthop Trauma 8:23–27CrossRefPubMed
10.
Broder K, Christiano A, Zuckerman JD, Egol K (2013) Management of proximal humerus fractures with the Equinoxe locking plate system. Bull Hosp Joint Dis 73:107–110
11.
12.
Sanz Reig J, Bendala Tufanisco C, Lizaur Utrilla A, Cebrián Gómez R (2003) El enclavado percutáneo en el tratamiento de las fracturas desplazadas en dos y tres fragmentos de la extremidad proximal del húmero. Rev Ortop Traumatol 47:26–30
13.
Martin C, Guillen M, Lopez G (2006) Treatment of 2- and 3-part fractures of the proximal humerus using external fixation: a retrospective evaluation of 62 patients. Acta Orthop 77:275–278CrossRefPubMed
14.
Monga P, Verma R, Sharma VK (2009) Closed reduction and external fixation for displaced proximal humeral fractures. J Orthop Surg 17:142–145CrossRef
15.
Schliemann B, Hartensuer R, Koch T, Theisen C, Raschke MJ, Kösters C, Weimann A (2015) Treatment of proximal humerus fractures with a CFR-PEEK plate: 2-year results of a prospective study and comparison to fixation with a conventional locking plate. J Shoulder Elbow Surg 24:1282–1288CrossRefPubMed
16.
Young AA, Hughes JS (2008) Locked intramedullary nailing for treatment of displaced proximal humerus fractures. Orthop Clin North Am 39:417–428CrossRefPubMed
17.
Lopiz Y, Garcia-Coiradas J, Garcia-Fernandez C, Marco F (2014) Proximal humerus nailing: a randomized clinical trial between curvilinear and straight nails. J Shoulder Elbow Surg 23:369–376CrossRefPubMed
18.
Kristiansen B (1987) External fixation of proximal humerus fracture. Clinical and cadaver study of pinning technique. Acta Orthop Scand 58:645–648CrossRefPubMed
19.
Kristiansen B, Kofoed H (1988) Transcutaneous reduction and external fixation of displaced fractures of the proximal humerus. A controlled clinical trial. J Bone Joint Surg Br 70:821–824CrossRefPubMed
20.
Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164
21.
Amstutz HC, Sew Hoy AL, Clarke IC (1981) UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res 155:7–20
22.
Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 29:602–608CrossRefPubMed
23.
Ware JE, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed
24.
Solberg BD, Moon CN, Franco DP, Paiement GD (2009) Surgical treatment of three and four-part proximal humeral fractures. J Bone Joint Surg Am 91:1689–1697CrossRefPubMed
25.
26.
Plecko M, Kraus A (2005) Internal fixation of proximal humerus fractures using the locking proximal humerus plate. Oper Orthop Traumatol 17:25–50CrossRefPubMed
27.
Gerber C, Werner CM, Vienne P (2004) Internal fixation of complex fractures of the proximal humerus. J Bone Joint Surg Br 86:848–855CrossRefPubMed
28.
Moonot P, Ashwood N, Hamlet M (2007) Early results for treatment of three- and four-part fractures of the proximal humerus using the PHILOS plate system. J Bone Joint Surg Br 89:1206–1209CrossRefPubMed
29.
Konrad G, Bayer J, Hepp P, Voigt C, Oestern H, Kääb M, Luo C, Plecko M, Wendt K, Köstler W, Südkamp N (2010) Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate Surgical technique. J Bone Joint Surg Am 92(Suppl 1 Pt 1):85–95CrossRefPubMed
30.
Ruchholtz S, Hauk C, Lewan U, Franz D, Kühne C, Zettl R (2011) Minimally invasive polyaxial locking plate fixation of proximal humeral fractures: a prospective study. J Trauma 71:1737–1744PubMed
31.
Giannoudis PV, Xypnitos FN, Dimitriou R, Manidakis N, Hackney R (2012) Internal fixation of proximal humeral fractures using the Polarus intramedullary nail: our institutional experience and review of the literature. J Orthop Surg Res 7:39CrossRefPubMedPubMedCentral
32.
Rajasekhar C, Ray PS, Bhamra MS (2001) Fixation of proximal humeral fractures with the Polarus nail. J Shoulder Elbow Surg 10:7–10CrossRefPubMed
33.
Sforzo CR, Wright TW (2009) Treatment of acute proximal humerus fractures with a polarus nail. J Surg Orthop Adv 18:28–34PubMed
34.
Popescu D, Fernandez-Valencia JA, Rios M, Cuñé J, Domingo A, Prat S (2009) Internal fixation of proximal humerus fractures using the T2-proximal humeral nail. Arch Orthop Trauma Surg 129:1239–1244CrossRefPubMed
35.
Adedapo AO, Ikpeme JO (2001) The results of internal fixation of three and four-part proximal humeral fractures with the Polarus nail. Injury 32:115–121CrossRefPubMed
36.
Owsley KC, Gorczyca JT (2008) Fracture displacement and screw cut out after open reduction and locked plate fixation of proximal humeral fractures [corrected]. J Bone Joint Surg Am 90:233–240CrossRefPubMed
37.
Krappinger D, Bizzotto N, Riedmann S, Kammerlander C, Hengg C, Kralinger FS (2011) Predicting failure after surgical fixation of proximal humerus fractures. Injury 42:1283–1288CrossRefPubMed
38.
Bogner R, Hübner C, Matis N, Auffarth A, Lederer S, Resch H (2008) Minimally-invasive treatment of three and four-part fractures of the proximal humerus in elderly patients. J Bone Joint Surg Br 90:1602–1607CrossRefPubMed
39.
Bonnevialle N, Ibnoulkatib A, Mansat P, Bonnevialle P (2013) Kapandji pinning and tuberosities fixation of three and four-part fractures of the proximal humerus. Int Orthop 37:1965–1971CrossRefPubMedPubMedCentral
40.
Kodraliu G, Mosconi P, Groth N, Carmosino G, Perilli A, Gianicolo EA, Rossi C, Apolone G (2001) Subjective health status assessment: evaluation of the Italian version of the SF-12 Health Survey. Results from the MiOS Project. J Epidemiol Biostat 6:305–316CrossRefPubMed
Metadata
Title
A prospective study for the treatment of proximal humeral fractures with the Galaxy Fixation System
Authors
R. D’Ambrosi
F. Palumbo
A. Barbato
R. M. Facchini
Publication date
01-04-2017
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue 1/2017
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-016-0434-z

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