Fluoroscopic Technique for Open Reduction and Internal Fixation of Proximal Humeral Fracture Using the Proximal Humeral Locking Plate: Proposal of “Plate” and “Screw” Views
Proximal humeral fractures are common injuries with increasing incidence, particularly in the aging population. Nondisplaced or minimally displaced fractures can be treated conservatively whereas surgical fixation is usually indicated in the cases of displaced fractures. Various surgical options hav...
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2017-08-01
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doaj-63d34329015b4024a13fcaee486338192021-06-10T04:54:03ZengElsevierArthroscopy Techniques2212-62872017-08-0164e1009e1014Fluoroscopic Technique for Open Reduction and Internal Fixation of Proximal Humeral Fracture Using the Proximal Humeral Locking Plate: Proposal of “Plate” and “Screw” ViewsWichan Kanchanatawan, M.D.0Sunikom Suppauksorn, M.D.1Worawit Densiri-aksorn, M.D.2Piyabuth Kittithamvongs, M.D.3Warongporn Pongpinyopap, M.D.4Address correspondence to Wichan Kanchanatawan, M.D., Department of Orthopedics, Lerdsin General Hospital, Bangkok 10500, Thailand.; Department of Orthopedics, Lerdsin General Hospital, Bangkok, ThailandDepartment of Orthopedics, Lerdsin General Hospital, Bangkok, ThailandDepartment of Orthopedics, Lerdsin General Hospital, Bangkok, ThailandDepartment of Orthopedics, Lerdsin General Hospital, Bangkok, ThailandDepartment of Orthopedics, Lerdsin General Hospital, Bangkok, ThailandProximal humeral fractures are common injuries with increasing incidence, particularly in the aging population. Nondisplaced or minimally displaced fractures can be treated conservatively whereas surgical fixation is usually indicated in the cases of displaced fractures. Various surgical options have been used for treatment of these fractures. Good outcomes have been reported with use of the Proximal Humeral Internal Locking System (PHILOS plate; Synthes, Zuchwil, Switzerland) as the implant of choice. However many complications have been reported, including varus malalignment, excessive retroversion of the articular part of the humerus, penetration of screws, and avascular necrosis of the humeral head. Therefore, we have hypothesized that an inadequate intraoperative fluoroscopic assessment may be an important factor contributing to these complications. We have described a step-by-step intraoperative fluoroscopic setup, including the proposal of a plate and screw view, focusing on the accuracy of reduction and proper placement of the PHILOS plate to prevent the complications previously described.http://www.sciencedirect.com/science/article/pii/S2212628717300749 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Wichan Kanchanatawan, M.D. Sunikom Suppauksorn, M.D. Worawit Densiri-aksorn, M.D. Piyabuth Kittithamvongs, M.D. Warongporn Pongpinyopap, M.D. |
spellingShingle |
Wichan Kanchanatawan, M.D. Sunikom Suppauksorn, M.D. Worawit Densiri-aksorn, M.D. Piyabuth Kittithamvongs, M.D. Warongporn Pongpinyopap, M.D. Fluoroscopic Technique for Open Reduction and Internal Fixation of Proximal Humeral Fracture Using the Proximal Humeral Locking Plate: Proposal of “Plate” and “Screw” Views Arthroscopy Techniques |
author_facet |
Wichan Kanchanatawan, M.D. Sunikom Suppauksorn, M.D. Worawit Densiri-aksorn, M.D. Piyabuth Kittithamvongs, M.D. Warongporn Pongpinyopap, M.D. |
author_sort |
Wichan Kanchanatawan, M.D. |
title |
Fluoroscopic Technique for Open Reduction and Internal Fixation of Proximal Humeral Fracture Using the Proximal Humeral Locking Plate: Proposal of “Plate” and “Screw” Views |
title_short |
Fluoroscopic Technique for Open Reduction and Internal Fixation of Proximal Humeral Fracture Using the Proximal Humeral Locking Plate: Proposal of “Plate” and “Screw” Views |
title_full |
Fluoroscopic Technique for Open Reduction and Internal Fixation of Proximal Humeral Fracture Using the Proximal Humeral Locking Plate: Proposal of “Plate” and “Screw” Views |
title_fullStr |
Fluoroscopic Technique for Open Reduction and Internal Fixation of Proximal Humeral Fracture Using the Proximal Humeral Locking Plate: Proposal of “Plate” and “Screw” Views |
title_full_unstemmed |
Fluoroscopic Technique for Open Reduction and Internal Fixation of Proximal Humeral Fracture Using the Proximal Humeral Locking Plate: Proposal of “Plate” and “Screw” Views |
title_sort |
fluoroscopic technique for open reduction and internal fixation of proximal humeral fracture using the proximal humeral locking plate: proposal of “plate” and “screw” views |
publisher |
Elsevier |
series |
Arthroscopy Techniques |
issn |
2212-6287 |
publishDate |
2017-08-01 |
description |
Proximal humeral fractures are common injuries with increasing incidence, particularly in the aging population. Nondisplaced or minimally displaced fractures can be treated conservatively whereas surgical fixation is usually indicated in the cases of displaced fractures. Various surgical options have been used for treatment of these fractures. Good outcomes have been reported with use of the Proximal Humeral Internal Locking System (PHILOS plate; Synthes, Zuchwil, Switzerland) as the implant of choice. However many complications have been reported, including varus malalignment, excessive retroversion of the articular part of the humerus, penetration of screws, and avascular necrosis of the humeral head. Therefore, we have hypothesized that an inadequate intraoperative fluoroscopic assessment may be an important factor contributing to these complications. We have described a step-by-step intraoperative fluoroscopic setup, including the proposal of a plate and screw view, focusing on the accuracy of reduction and proper placement of the PHILOS plate to prevent the complications previously described. |
url |
http://www.sciencedirect.com/science/article/pii/S2212628717300749 |
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