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Archives of Orthopaedic and Trauma Surgery

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01-11-2010 | Trauma Surgery

Elastic stabilisation of proximal humeral fractures with a new percutaneous angular stable fixation device (ButtonFix^®): a preliminary report

Authors: Jens Arne Jöckel, Alexander Brunner, Sebastian Thormann, Reto Babst

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2010

Abstract

Introduction

The ButtonFix^® system represents a new angular stable percutaneous fixation device for stabilisation of fractures of the proximal humerus. The purpose of this study was to present a preliminary report of the radiological and clinical outcome after minimally invasive stabilisation of selected proximal humerus fractures with the ButtonFix^®.

Patients and methods

Seventeen patients with fractures of the proximal humerus were treated in our department with the ButtonFix^® system. The mean final follow-up was performed 19 months postoperatively. Follow-up included assessment of postoperative reposition, range of motion, the DASH score, the Constant–Murley score, and the Short Form 36 (SF36).

Results

Twelve patients showed anatomical head-to-shaft angles, four revealed minor valgus replacement, and one minor varus replacement. In one patient unplanned revision surgery was necessary due to early secondary fracture dislocation requiring ORIF with an angular stable form plate. Implant removal was performed after 6 weeks in all patients. At the final follow-up, mean range of motion was: flexion 135°, extension 45°, abduction 142°, internal rotation 51°, and external rotation 62°. The mean Constant–Murley score was 70. The mean DASH score was 26 points and the average SF36 score was 76 points. One patient showed radiological signs of avascular necrosis.

Conclusion

The ButtonFix^® system represents a valuable tool in the treatment of proximal humeral fractures with results indicating fewer complications compared to prior percutaneous fixation devices. Moreover, the ButtonFix^® seems to be able to maintain reduction even in elderly patients with potentially reduced bone mass.

Chen CY, Chao EK, Tu YK, Ueng SW, Shih CH (1998) Closed management and percutaneous fixation of unstable proximal humerus fractures. J Trauma 45(6):1039–1045CrossRefPubMed

Cornell CN (1994) Tension-band wiring supplemented by lag-screw fixation of proximal humerus fractures: a modified technique. Orthop Rev Suppl:19–23

Demirhan M, Kilicoglu O, Altinel L, Eralp L, Akalin Y (2003) Prognostic factors in prosthetic replacement for acute proximal humerus fractures. J Orthop Trauma 17(3):181–188 (discussion 8–9)CrossRefPubMed

Hintermann B, Trouillier HH, Schafer D (2000) Rigid internal fixation of fractures of the proximal humerus in older patients. J Bone Jt Surg Br 82(8):1107–1112CrossRef

Hirschmann MT, Quarz V, Audige L, Ludin D, Messmer P, Regazzoni P, Gross T (2007) Internal fixation of unstable proximal humerus fractures with an anatomically preshaped interlocking plate: a clinical and radiologic evaluation. J Trauma 63(6):1314–1323CrossRefPubMed

Mihara K, Tsutsui H, Suzuki K, Makiuchi D, Nishinaka N, Yamaguchi K (2008) New intramedullary nail for the surgical neck fracture of the proximal humerus in elderly patients. J Orthop Sci 13(1):56–61CrossRefPubMed

Park MC, Murthi AM, Roth NS, Blaine TA, Levine WN, Bigliani LU (2003) Two-part and three-part fractures of the proximal humerus treated with suture fixation. J Orthop Trauma 17(5):319–325CrossRefPubMed

Skutek M, Fremerey R, Bosch U (1998) Level of physical activity in elderly patients after hemiarthroplasty for three- and four-part fractures of the proximal humerus. Arch Orthop Trauma Surg 117:252–255CrossRefPubMed

Wanner GA, Wanner-Schmid E, Romero J, Hersche O, von Smekal A, Trentz O, Ertel W (2003) Internal fixation of displaced proximal humeral fractures with two-one-third tubular plates. J Trauma 54(3):536–544CrossRefPubMed

10.

Wijgman AJ, Roolker W, Patt TW, Raaymakers EL, Marti RK (2002) Open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus. J Bone Jt Surg Am 84-A(11):1919–1925

11.

Brunner F, Sommer C, Bahrs C, Heuwinkel R, Hafner C, Rillmann P, Kohut G, Ekelund A, Muller M, Audige L, Babst R (2009) Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma 23(3):163–172CrossRefPubMed

12.

Charalambous CP, Siddique I, Valluripalli K, Kovacevic M, Panose P, Srinivasan M, Marynissen H (2007) Proximal humeral internal locking system (PHILOS) for the treatment of proximal humeral fractures. Arch Orthop Trauma Surg 127(3):205–210CrossRefPubMed

13.

Fenichel I, Oran A, Burstein G, Perry Pritsch M (2006) Percutaneous pinning using threaded pins as a treatment option for unstable two- and three-part fractures of the proximal humerus: a retrospective study. Int Orthop 30(3):153–157CrossRefPubMed

14.

Jaberg H, Warner JJ, Jakob RP (1992) Percutaneous stabilization of unstable fractures of the humerus. J Bone Jt Surg Am 74(4):508–515

15.

Resch H, Hubner C, Schwaiger R (2001) Minimally invasive reduction and osteosynthesis of articular fractures of the humeral head. Injury 32(Suppl 1):SA25–SA32

16.

Duda GN, Epari DR, Babst R, Lambert SM, Matthys R, Sudkamp NP (2007) Mechanical evaluation of a new minimally invasive device for stabilization of proximal humeral fractures in elderly patients: a cadaver study. Acta Orthop 78(3):430–435CrossRefPubMed

17.

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(6):602–608CrossRefPubMed

18.

Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMed

19.

Bullinger M, Kirchberger I (1998) SF36 Questionnaire concerning Health status. Hogrefe, Göttingen

20.

Aschauer E, Resch H, Hubner C (2007) Percutaneous osteosynthesis of humeral head fractures. Oper Orthop Traumatol 19(3):276–293CrossRefPubMed

21.

Gerber C, Werner CM, Vienne P (2004) Internal fixation of complex fractures of the proximal humerus. J Bone Jt Surg Br 86(6):848–855CrossRef

22.

Hawkins RJ, Bell RH, Gurr K (1986) The three-part fracture of the proximal part of the humerus. Operative treatment. J Bone Jt Surg Am 68(9):1410–1414

23.

Savoie FH, Geissler WB, Vander Griend RA (1989) Open reduction and internal fixation of three-part fractures of the proximal humerus. Orthopedics 12(1):65–70PubMed

24.

Bogner R, Hubner 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 Jt Surg Br 90(12):1602–1607CrossRef

25.

Kralinger F, Irenberger A, Lechner C, Wambacher M, Golser K, Sperner G (2006) Comparison of open versus percutaneous treatment for humeral head fracture. Unfallchirurg 109(5):406–410

26.

Lill H, Hepp P, Korner J (2003) Proximal humeral fractures: how stiff should an implant be? A comparative mechanical study with new implants in human specimens. Arch Orthop Trauma Surg 123(2):74–81PubMed

Title: Elastic stabilisation of proximal humeral fractures with a new percutaneous angular stable fixation device (ButtonFix®): a preliminary report
Authors: Jens Arne Jöckel
Alexander Brunner
Sebastian Thormann
Reto Babst
Publication date: 01-11-2010
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2010
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-010-1088-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Elastic stabilisation of proximal humeral fractures with a new percutaneous angular stable fixation device (ButtonFix^®): a preliminary report

Abstract

Introduction

Patients and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusion

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