| Internal fixation of fractures of the proximal humerus with the MultiLoc nail. | |
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MedLine Citation:
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PMID: 23015093 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Anatomical reduction of two- to four-part fractures of the proximal humerus using indirect reduction techniques. Intramedullary fixation with a short humerus nail. Restoration of a stable bone-implant construct that enables early functional after-treatment. INDICATIONS: Displaced and unstable two- to four-part fractures of the proximal humerus. Fractures of the proximal humerus extending in the humeral diaphysis (use a long nail). Ipsilateral combined lesions of the proximal humerus and the humeral diaphysis (use a long nail). CONTRAINDICATIONS: Poor physical and/or mental status. Critical soft tissue conditions in the area near the surgical site. Local soft tissue infection. Pre-existing severe osteoarthritis of the shoulder joint; severe shoulder stiffness. Head-split fractures of the humerus head that cannot be reduced. SURGICAL TECHNIQUE: Exposure of the fracture using an anterior acromial approach and determination of the correct nail entrance point. Anatomic fracture reduction using indirect reduction techniques. Stable fixation using an intramedullary MultiLoc® nail. Determination of the proximal locking configuration depending on the fracture morphology. Distal locking with angle-stable option. POST-OPERATIVE TREATMENT: Post-operative radiographs for documentation of the surgical result and implant position. Use of an arm sling for 7-10 days. Active and passive exercises of the shoulder joint starting on day 1. Shoulder abduction limited to 60° for 2 weeks. Subsequent abduction to 90° until the 4th week. Subsequent active mobilisation without restrictions. Weight bearing and sporting activities after 3 months. Radiological evaluation after 2, 6 and 12 weeks. RESULTS: During a 6-month period, 160 patients were documented in a prospective clinical multicentre study. According to the AO classification, there were 36% A-type fractures, 41% B- and 23% C-type injuries. A 6-month follow-up was available for 17 patients. The mean age of these patients was 67 years. One patient had an A-type fracture. There were ten B- and six C-type fractures. At the time of follow-up, the mean Constant score was 66 points. Radiographically, all fractures had healed. Intra-articular screw penetration and loss of reduction were both observed once. |
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Authors:
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M H Hessmann; S Nijs; T Mittlmeier; M Kloub; M J M Segers; V Winkelbach; M Blauth |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-9-28 |
Journal Detail:
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Title: Operative Orthopadie und Traumatologie Volume: - ISSN: 1439-0981 ISO Abbreviation: Oper Orthop Traumatol Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9604937 Medline TA: Oper Orthop Traumatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Orthopedics and Trauma Surgery, Academic Teaching Hospital Fulda, Pacelliallee 4, 36043, Fulda, Germany, Martin.Hessmann@klinikum-fulda.de. |
Vernacular Title:
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Innere Fixation proximaler Humerusfrakturen mit dem MultiLoc-Nagel. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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