Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 9/2017

01-09-2017 | Trauma Surgery

Management of proximal humeral fractures by the Ilizarov external fixator

Authors: Mohammed Anter Meselhy, Mohamed Salah Singer

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2017

Login to get access

Abstract

Introduction

External fixation can be performed in poor bone and soft tissue conditions, and can be used in patients with poor general conditions or multiple injuries as a rapid, mini-invasive procedure. The purpose of the current study was to evaluate the effectiveness and safety of the Ilizarov external fixator in the management of proximal humeral fractures.

Materials and methods

Between May 2011 and December 2013, 14 patients with displaced proximal humeral fractures were enrolled in the current study. Nine patients were males and five were females, with mean age 42.9 years (range 21–55). All fractures were acute. The mode of injury was road traffic accident in eight patients and fall in six patients. There were six patients with two-part fracture, one of them with fracture dislocation, and eight patients presented with three-part fracture, two of them with fracture dislocation. All fractures were fixed using the Ilizarov external fixation.

Results

The average operative time was about 67 min (range 50–90). The mean follow-up period was (18) months (range 12–28). Healing was obtained in all 14 patients in a mean of 10.4 weeks (range 8–14). At the final follow-up, the mean constant score was 73.1 points (range 60–97 points), the mean visual analog score (VAS) for pain 3.2 (range 1–5), the mean DASH score 31.8 points (range 10–55 points), and the mean satisfaction VAS 7.6 (range 4–10).

Conclusion

The Ilizarov external fixation is an effective technique in managing proximal humeral fractures with good outcome and low complication rates.

Level of evidence

Level IV, case series.
Literature
1.
go back to reference Neer C (1970) Displaced proximal humerus fractures. Part1. Classification and evaluation. J Bone Joint Surg (Am) 52(6):1077–1089CrossRef Neer C (1970) Displaced proximal humerus fractures. Part1. Classification and evaluation. J Bone Joint Surg (Am) 52(6):1077–1089CrossRef
2.
go back to reference Brorson S (2013) Fractures of the proximal humerus: history, classification, and management. Acta Orthop 84(Supp 351):1–32CrossRef Brorson S (2013) Fractures of the proximal humerus: history, classification, and management. Acta Orthop 84(Supp 351):1–32CrossRef
3.
go back to reference Drosdowech D, Faber K, Athwal G (2008) Open reduction and internal fixation of proximal humerus fractures. Orthop Clin N Am 39(4):429–439CrossRef Drosdowech D, Faber K, Athwal G (2008) Open reduction and internal fixation of proximal humerus fractures. Orthop Clin N Am 39(4):429–439CrossRef
4.
go back to reference Sisk T (1983) External fixation. Historic review, advantages, disadvantages, complications, and indications. Clin Orthop Relat Res 180:15–22 Sisk T (1983) External fixation. Historic review, advantages, disadvantages, complications, and indications. Clin Orthop Relat Res 180:15–22
5.
go back to reference Codman E (1934) Rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Thomas Todd, Boston Codman E (1934) Rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Thomas Todd, Boston
6.
go back to reference 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(2):275–278CrossRefPubMed 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(2):275–278CrossRefPubMed
7.
go back to reference Kristiansen B, Kofoed H (1987) External fixation of displaced fractures of the proximal humerus. Technique and preliminary results. J Bone Joint Surg Br 69(4):643–646PubMed Kristiansen B, Kofoed H (1987) External fixation of displaced fractures of the proximal humerus. Technique and preliminary results. J Bone Joint Surg Br 69(4):643–646PubMed
8.
go back to reference 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(5):821–824PubMed 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(5):821–824PubMed
9.
go back to reference Karatosun V, Alekberov C, Baran Ö, Serin E, Alici E, Balci C (2002) Open fractures of the proximal humerus treated with the Ilizarov method. Acta Orthop 73(4):460–464CrossRef Karatosun V, Alekberov C, Baran Ö, Serin E, Alici E, Balci C (2002) Open fractures of the proximal humerus treated with the Ilizarov method. Acta Orthop 73(4):460–464CrossRef
10.
go back to reference Chen C, Chao E, Ueng S, Shih C (1998) Closed management and percutaneous fixation of unstable proximal humerus fractures. J Trauma 45:1039–1045CrossRefPubMed Chen C, Chao E, Ueng S, Shih C (1998) Closed management and percutaneous fixation of unstable proximal humerus fractures. J Trauma 45:1039–1045CrossRefPubMed
11.
go back to reference Ebraheim N, Wong F, Biyani A (1996) Percutaneous pinning of the proximal humerus. Am J Orthop 25:501–506 Ebraheim N, Wong F, Biyani A (1996) Percutaneous pinning of the proximal humerus. Am J Orthop 25:501–506
12.
go back to reference Fenichel I, Oran A, Burstein G, Pritsch MP (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):153–157CrossRefPubMedPubMedCentral Fenichel I, Oran A, Burstein G, Pritsch MP (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):153–157CrossRefPubMedPubMedCentral
13.
go back to reference Dhar S, Butt M, Mir M, Ali M, Kawoosa A (2008) Use of the Ilizarov apparatus to improve alignment in proximal humeral fractures treated initially by a unilateral external fixator. Strateg Trauma Limb Reconst 3(3):119–122CrossRef Dhar S, Butt M, Mir M, Ali M, Kawoosa A (2008) Use of the Ilizarov apparatus to improve alignment in proximal humeral fractures treated initially by a unilateral external fixator. Strateg Trauma Limb Reconst 3(3):119–122CrossRef
14.
go back to reference Uzer G, Yıldız F, Author E, Elmadağ M, Pulatkan K (2015) Treatment of unusual proximal humeral fractures using unilateral external fixator: a case series. Eur J Orthop Surg Traumatol 25(4):683–687CrossRefPubMed Uzer G, Yıldız F, Author E, Elmadağ M, Pulatkan K (2015) Treatment of unusual proximal humeral fractures using unilateral external fixator: a case series. Eur J Orthop Surg Traumatol 25(4):683–687CrossRefPubMed
15.
go back to reference Sproul R, Iyengar J, Devcic Z, Feeley B (2011) A systematic review of locking plate fixation of proximal humerus fractures. Injury 42(4):408–413CrossRefPubMed Sproul R, Iyengar J, Devcic Z, Feeley B (2011) A systematic review of locking plate fixation of proximal humerus fractures. Injury 42(4):408–413CrossRefPubMed
16.
go back to reference Aguado H, Mingo J, Torres M, Alvarez-Ramos A, Martín-Ferrero M (2016) Minimally invasive polyaxial locking plate osteosynthesis for 3–4 part proximal humeral fractures: our institutional experience. Injury 47(Suppl3):S22–S28CrossRefPubMed Aguado H, Mingo J, Torres M, Alvarez-Ramos A, Martín-Ferrero M (2016) Minimally invasive polyaxial locking plate osteosynthesis for 3–4 part proximal humeral fractures: our institutional experience. Injury 47(Suppl3):S22–S28CrossRefPubMed
17.
go back to reference Ruchholtz S, Hauk C, Lewan U, Franz D (2011) CKühne. Minimally invasive polyaxial locking plate fixation of proximal humeral fractures: a prospective study. J Trauma 71(6):1737–1744PubMed Ruchholtz S, Hauk C, Lewan U, Franz D (2011) CKühne. Minimally invasive polyaxial locking plate fixation of proximal humeral fractures: a prospective study. J Trauma 71(6):1737–1744PubMed
Metadata
Title
Management of proximal humeral fractures by the Ilizarov external fixator
Authors
Mohammed Anter Meselhy
Mohamed Salah Singer
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 9/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-017-2749-0

Other articles of this Issue 9/2017

Archives of Orthopaedic and Trauma Surgery 9/2017 Go to the issue