18. TREATMENT OF PROXIMAL HUMURUS FRACTURE WITH MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS AT CU CHI DISTRICT HOSPITAL
Main Article Content
Abstract
Background: Proximal humerus fracture are common fractures and have many treatment methodsOne of the recent methods applied in Vietnam is osteosynthesis by plate with minimal incision using minimally invasive plate osteosynthesis technique. Since 2019, Cu Chi District Hospital has applied the technique. This treatment treats patients with proximal humerus fractures. To summarize and evaluate the effectiveness of the method, we conducted the study “Treatment of proximal humerus fracture by plate with minimal incision at Cu Chi district hospital”.
Objectives: Evaluating the results of restoration of head – humerus shaft angle, shoulder rehabilitation and description of complications. Materials and
Methods: Retrospective, clinical case series description. Collecting data on the medical records of patients undergoing MIPO surgery for humeral head fracture from December 2019 to February 2023 and performed clinical and subclinical examinations directly on the patient.
Results: 33 patients (23 women, 10 men), age: 64.67 ± 14.05 (32 – 88 years), AO classification: A2 (12 patients), A3 (4 patients), B1 (16 patients), C1 (01 patient), rehabilitation period is 26.06 months (6 – 44 months). Union period is 13,64 weeks (12 – 16 weeks). Head – humerus shaft angle is 132.65° ± 5.07° (117.83° – 140.84°), results according to Paavolainen: 32/33 good, 1/33 moderate. The rehabilitation score according to Constant Murley is 69.58 ±10.05, the result of rehabilitation according to Boehm: 27/33 (81,8%) excellent, 3/33 (9,1%) good, 2/33 (6,1%) satisfactory, 1/33 (3%) poor. There were 4/33 12,1%) complications including: 1 superficial infection, 2 temporary axillary nerve damage, 1 shoulder stiffness.
Conclusion: MIPO proximal humerus fracture resulted in restoration of the humerus stem angle, good function recovery, and few complications.
Article Details
Keywords
Proximal humeral fracture, MIPO.
References
Humeral Fracture Fixation with PHILOS Plate
using Minimal Invasive Percutaneous Plate
Osteosynthesis (MIPPO) Technique: A Series
of 30 Patients, Malaysian Orthopaedic Journal,
12(2), 2018, 20-24.
[2] Alberio RL., Research Article Minimally
Invasive Plate Osteosynthesis for Proximal
Humerus Fractures: A Retrospective Study
Describing Principles and Advantages of the
Technique, Adv Orthop, 2018, 5904028.
[3] Gönç U, Atabek M, Teker K et al., Minimally153
invasive plate osteosynthesis with PHILOS plate
for proximal humerus fractures. Acta orthopaedica
et traumatologica turcica. Jan 2017;51(1):17-22.
doi:10.1016/j.aott.2016.10.003Visser CP, Coene
LN, Brand R, et al. Nerve lesions in proximal
humeral fractures. JShoulder Elbow Surg.
2001;10(5):421–427.
[4] Lin T, Xiao B, Ma X et al., Minimally invasive
plate osteosynthesis with a locking compression
plate is superior to open reduction and internal
fixation in the management of the proximal
humerus fractures. BMC musculoskeletal
disorders. Jun 16 2014;15:206. doi:10.1186/1471-
2474-15-206.
[5] Liu K, Liu PC, Liu R et al., Advantage of
minimally invasive lateral approach relative
to conventional deltopectoral approach for
treatment of proximal humerus fractures. Medical
science monitor : international medical journal
of experimental and clinical research. Feb 15
2015;21:496-504. doi:10.12659/msm.893323.
[6] Diệp Minh Quân, Đặc điểm hình thái CT-Scan
chỏm xương cánh tay người Việt Nam, Luận văn
cao học, Trường đại học Y dược thành phố Hồ
Chí Minh, 2022.
[7] Jung SW, Indirect reduction maneuver and
minimally invasive approach for displaced
proximal humerus fractures in elderly patients.
Clinics in orthopedic surgery. Mar 2013;5(1):66-
73. doi:10.4055/cios.2013.5.1.66.
[8] Kim YG, Park KH, Kim JW et al., Is
minimally invasive plate osteosynthesis
superior to open plating for fixation of twopart
fracture of the proximal humerus?
Journal of orthopaedic surgery (Hong Kong).
May-Aug 2019;27(2):2309499019836156.
doi:10.1177/2309499019836156.
[9] Quách Khang Hy, Khảo sát sức cơ vai người
Việt Nam theo cách tính điểm Constant; Y học
Thành phố Hồ Chí Minh, 2014;18(1):430 - 437.
[10] Visser CP, Coene LN, Brand R et al., Nerve lesions
in proximal humeral fractures; Journal of shoulder
and elbow surgery. Sep-Oct 2001;10(5):421-7.
doi:10.1067/mse.2001.118002
[11] Oldrini LM, Feltri P, Albanese J et al., PHILOS
Synthesis for Proximal Humerus Fractures Has
High Complications and Reintervention Rates:
A Systematic Review and Meta-Analysis.
Life (Basel, Switzerland). Feb 19 2022;12(2)
doi:10.3390/life12020311.