Top

International Orthopaedics

Published in:

01-07-2021 | Osteonecrosis | Original Paper

Comparison of “Bilboquet” device and locking plate for surgical treatment of proximal humerus complex fractures at two years follow-up

Authors: Yaniv Bismuth, Adeline Cambon-Binder, Alain Sautet, Levon Doursounian, Thomas Gregory, Claire Bastard

Published in: International Orthopaedics | Issue 7/2021

Abstract

Purpose

Surgical treatment of three or four part fractures of the proximal humerus is complex. Different conservative techniques have been described. The main goal of this study was to compare the clinical and radiological outcomes of Bilboquet and locking plate at two year follow-up.

Methods

This is a retrospective, comparative study, with a continuous series of 41 patients. Bony fixation was achieved with a Bilboquet device in 22 patients or a locking plate in 19 patients. Patient evaluation included clinical data: shoulder range of motion, Constant–Murley shoulder score and DASH (Disabilities of the Arm, Shoulder and Hand) score, and imaging using standard shoulder X-rays.

Results

Of the 41 patients included, 1 patient was lost to follow-up in the locking plate group. At a mean follow-up of 24 months patients in Bilboquet group showed a Constant score higher than in locking plate (p = 0.02). Range of motion and DASH score were not significantly different between the two groups. avascular necrosis occured in three patients of Bilboquet group (14%) versus in two patients in the locking plate group (11%) (p > 0.5). Complication and reintervention rate were non-significantly higher in the locking plate group than in the Bilboquet group (37 vs 14%).

Conclusion

Bilboquet and locking plate give good functional outcomes in complex proximal humerus fractures. However, the Bilboquet device appears to provide better functional results than locking plate at mid-term follow-up.

Lanting B, MacDermid J, Drosdowech D, Faber KJ (2008) Proximal humeral fractures : A systematic review of treatment modalities. J Shoulder Elb Surg 17(1):42–54. https://doi.org/10.1016/j.jse.2007.03.016CrossRef

Stableforth PG (1984) Four-part fractures of the neck of the humerus. The Journal of Bone and Joint Surgery. Br Vol 66(1):104–108

Akalın Y, Şahin İG, Çevik N, Güler BO, Avci Ö, Öztürk A (2020) Locking compression plate fixation versus intramedullary nailing of humeral shaft fractures: Which one is better? A single-centre prospective randomized study. Int Orthop. https://doi.org/10.1007/s00264-020-04696-6

Doursounian L, Grimberg J, Cazeau C, Jos E, Touzard RC (2000) A new internal fixation technique for fractures of the proximal humerus--the Bilboquet device : A report on 26 cases. J Shoulder Elb Surg 9(4):279–288. https://doi.org/10.1067/mse.2000.106086CrossRef

Nowak LL, Dehghan N, McKee MD, Schemitsch EH (2018) Plate fixation for management of humerus fractures. Injury 49(Suppl 1):S33–S38. https://doi.org/10.1016/S0020-1383(18)30300-0CrossRefPubMed

Thanasas C, Kontakis G, Angoules A, Limb D, Giannoudis P (2009) Treatment of proximal humerus fractures with locking plates: a systematic review. J Shoulder Elb Surg 18(6):837–844CrossRef

Doursounian L, Kilinc A, Cherrier B, Nourissat G (2011) Complex proximal humeral fractures : A prospective study of 22 cases treated using the « Bilboquet » device. Orthop Traumatol Surg Res: OTSR 97(1):58–66. https://doi.org/10.1016/j.otsr.2010.06.015CrossRefPubMed

Doursounian L, Le Sant A, Mauprivez R, Miquel A, Beauthier-Landauer V (2016) Open reduction and internal fixation of three- and four-part proximal humeral fractures by intra-focal distraction : Observational study of twenty five cases. Int Orthop 40(11):2373–2382. https://doi.org/10.1007/s00264-015-3109-8CrossRefPubMed

Neer CS (2002) Four-segment classification of proximal humeral fractures : Purpose and reliable use. J Shoulder Elb Surg 11(4):389–400. https://doi.org/10.1067/mse.2002.124346CrossRef

10.

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

11.

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):602–608. https://doi.org/10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-LCrossRefPubMed

12.

Maier D, Jaeger M, Izadpanah K, Strohm PC, Suedkamp NP (2014) Proximal humeral fracture treatment in adults. The Journal of Bone and Joint Surgery. Am Vol 96(3):251–261. https://doi.org/10.2106/JBJS.L.01293CrossRef

13.

Soliman OA, Koptan WMT (2013) Four-part fracture dislocations of the proximal humerus in young adults : Results of fixation. Injury 44(4):442–447. https://doi.org/10.1016/j.injury.2012.09.005CrossRefPubMed

14.

Chen L, Xing F, Xiang Z (2016) Effectiveness and safety of interventions for treating adults with displaced proximal humeral fracture : A Network Meta-Analysis and Systematic Review. PLoS One 11(11):e0166801. https://doi.org/10.1371/journal.pone.0166801CrossRefPubMedPubMedCentral

15.

Roberson TA, Bentley JC, Griscom JT, Kissenberth MJ, Tolan SJ, Hawkins RJ, Tokish JM (2017) Outcomes of total shoulder arthroplasty in patients younger than 65 years : A systematic review. J Shoulder Elb Surg 26(7):1298–1306. https://doi.org/10.1016/j.jse.2016.12.069CrossRef

16.

Valenti P, Zampeli F, Ciais G, Kany J, Katz D (2020) The initial treatment of complex proximal humerus fracture affects the outcome of revision with reverse shoulder arthroplasty. Int Orthop 44(7):1331–1340. https://doi.org/10.1007/s00264-020-04612-yCrossRefPubMed

17.

Sun Q, Wu X, Wang L, Cai M (2020) The plate fixation strategy of complex proximal humeral fractures. Int Orthop. https://doi.org/10.1007/s00264-020-04544-7

18.

Südkamp N, Bayer J, Hepp P, Voigt C, Oestern H, Kääb M, Luo C, Plecko M, Wendt K, Köstler W, Konrad G (2009) Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. Results of a prospective, multicenter, observational study. J Bone Joint Surg Am 91(6):1320–1328. https://doi.org/10.2106/JBJS.H.00006CrossRefPubMed

19.

Brunner F, Sommer C, Bahrs C, Heuwinkel R, Hafner C, Rillmann P, Kohut G, Ekelund A, Muller M, Audigé 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):163–172. https://doi.org/10.1097/BOT.0b013e3181920e5bCrossRefPubMed

20.

Hirschmann MT, Fallegger B, Amsler F, Regazzoni P, Gross T (2011) Clinical longer-term results after internal fixation of proximal humerus fractures with a locking compression plate (PHILOS). J Orthop Trauma 25(5):286–293. https://doi.org/10.1097/BOT.0b013e3181f2b20eCrossRefPubMed

21.

Erasmo R, Guerra G, Guerra L (2014) Fractures and fracture-dislocations of the proximal humerus : A retrospective analysis of 82 cases treated with the Philos(®) locking plate. Injury 45(Suppl 6):S43–S48. https://doi.org/10.1016/j.injury.2014.10.022CrossRefPubMed

22.

Hertel R, Hempfing A, Stiehler M, Leunig M (2004) Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elb Surg 13(4):427–433. https://doi.org/10.1016/j.jse.2004.01.034CrossRef

Title: Comparison of “Bilboquet” device and locking plate for surgical treatment of proximal humerus complex fractures at two years follow-up
Authors: Yaniv Bismuth
Adeline Cambon-Binder
Alain Sautet
Levon Doursounian
Thomas Gregory
Claire Bastard
Publication date: 01-07-2021
Publisher: Springer Berlin Heidelberg
Keyword: Osteonecrosis
Published in: International Orthopaedics / Issue 7/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-021-04967-w

At a glance: The STEP trials

Springer Medicine

Comparison of “Bilboquet” device and locking plate for surgical treatment of proximal humerus complex fractures at two years follow-up

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2021

A historical review and bibliometric analysis of research on fracture nonunion in the last three decades

Comparison of the accuracy of the cup position and orientation in total hip arthroplasty for osteoarthritis secondary to developmental dysplasia of the hip between the Mako robotic arm-assisted system and computed tomography-based navigation

Haematogenous Klebsiella pneumoniae osteomyelitis

Comparison of different fixation techniques for periprosthetic fractures: a biomechanical study of a new implant

Clinical impact of intraoperative cone beam tomography and navigation for displaced acetabular fractures: a comparative study at medium-term follow-up

Leukocyte esterase test and alpha-defensin test have similar accuracy for the diagnosis of periprosthetic joint infection