Russo Raffaele, Lombardi Luigi Vernaglia, Ciccarelli Michele, Giudice Gerardo, Cautiero Fabio
Pellegrini Hospital, Via Portamedina 41, Naples, Italy.
Chir Organi Mov. 2008 Jan;91(1):27-34. doi: 10.1007/s12306-007-0005-4. Epub 2008 Feb 10.
The treatment of third proximal humerus complex fractures represents a challenge and osteosynthesis techniques are still controversial. The Authors report a new device that has been planned and used to treat this type of fracture, suitable for both young and elderly patients. The device consists of a perforated prismatic-triangular titanium cage (PTTC), available in different sizes so that it can be inserted in the bone cavity as a bridge. Thus, it supports the cephalic cap and, resting on the metaepiphyseal walls, allows greater and lesser tuberosities to be restored using osteosutures or minimal osteosynthesis devices. Furthermore, bone chips or bone substitutes can be inserted as filling in the perforated parts. From June 2005 to February 2006 we used this osteosynthesis surgical technique to treat 10 patients, 4 females and 6 males, all affected by proximal humerus complex fractures. No specific complications during and after surgery were noticed. The reported results are still to be considered as preliminary, but they are very encouraging. In all the cases the effective internal stabilisation allowed anatomical reduction of fragments, their stable fixation, reconstruction close to standard anatomy and early rehabilitation.
肱骨近端复杂骨折的治疗是一项挑战,骨固定技术仍存在争议。作者报告了一种新设计并用于治疗此类骨折的器械,适用于年轻和老年患者。该器械由一个带孔的棱柱形三角形钛笼(PTTC)组成,有不同尺寸,可作为桥接物插入骨腔。因此,它支撑着肱骨头,靠在干骺端壁上,使用骨缝线或微创骨固定器械可恢复大、小粗隆。此外,骨碎片或骨替代物可作为填充物插入带孔部分。2005年6月至2006年2月,我们使用这种骨固定手术技术治疗了10例患者,其中4例女性,6例男性,均为肱骨近端复杂骨折患者。手术期间及术后未发现特殊并发症。报告的结果仍属初步,但非常令人鼓舞。在所有病例中,有效的内固定使骨折碎片实现解剖复位、稳定固定、接近标准解剖结构的重建以及早期康复。