The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study
<p>Abstract</p> <p>Background</p> <p>With new minimally-invasive approaches for angular stable plate fixation of proximal humeral fractures, the need for the placement of oblique inferomedial screws ('calcar screw') has increasingly been discussed. The purpose...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2011-09-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://www.josr-online.com/content/6/1/50 |
| _version_ | 1828395198333321216 |
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| author | Simmen Hans-Peter Wanner Guido A Ossendorf Christian Osterhoff Georg Werner Clément M |
| author_facet | Simmen Hans-Peter Wanner Guido A Ossendorf Christian Osterhoff Georg Werner Clément M |
| author_sort | Simmen Hans-Peter |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>With new minimally-invasive approaches for angular stable plate fixation of proximal humeral fractures, the need for the placement of oblique inferomedial screws ('calcar screw') has increasingly been discussed. The purpose of this study was to investigate the influence of calcar screws on secondary loss of reduction and on the occurrence of complications.</p> <p>Methods</p> <p>Patients with a proximal humeral fracture who underwent angular stable plate fixation between 01/2007 and 07/2009 were included. On AP views of the shoulder, the difference in height between humeral head and the proximal end of the plate were determined postoperatively and at follow-up. Additionally, the occurrence of complications was documented. Patients with calcar screws were assigned to group C+, patients without to group C-.</p> <p>Results</p> <p>Follow-up was possible in 60 patients (C+ 6.7 ± 5.6 M/C- 5.0 ± 2.8 M). Humeral head necrosis occurred in 6 (C+, 15.4%) and 3 (C-, 14.3%) cases. Cut-out of the proximal screws was observed in 3 (C+, 7.7%) and 1 (C-, 4.8%) cases. In each group, 1 patient showed delayed union. Implant failure or lesions of the axillary nerve were not observed. In 44 patients, true AP and Neer views were available to measure the head-plate distance. There was a significant loss of reduction in group C- (2.56 ± 2.65 mm) compared to C+ (0.77 ± 1.44 mm; p = 0.01).</p> <p>Conclusions</p> <p>The placement of calcar screws in the angular stable plate fixation of proximal humeral fractures is associated with less secondary loss of reduction by providing inferomedial support. An increased risk for complications could not be shown.</p> |
| first_indexed | 2024-12-10T08:08:39Z |
| format | Article |
| id | doaj.art-3979becd27f94554b3083103d69f910b |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-12-10T08:08:39Z |
| publishDate | 2011-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-3979becd27f94554b3083103d69f910b2022-12-22T01:56:37ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2011-09-01615010.1186/1749-799X-6-50The calcar screw in angular stable plate fixation of proximal humeral fractures - a case studySimmen Hans-PeterWanner Guido AOssendorf ChristianOsterhoff GeorgWerner Clément M<p>Abstract</p> <p>Background</p> <p>With new minimally-invasive approaches for angular stable plate fixation of proximal humeral fractures, the need for the placement of oblique inferomedial screws ('calcar screw') has increasingly been discussed. The purpose of this study was to investigate the influence of calcar screws on secondary loss of reduction and on the occurrence of complications.</p> <p>Methods</p> <p>Patients with a proximal humeral fracture who underwent angular stable plate fixation between 01/2007 and 07/2009 were included. On AP views of the shoulder, the difference in height between humeral head and the proximal end of the plate were determined postoperatively and at follow-up. Additionally, the occurrence of complications was documented. Patients with calcar screws were assigned to group C+, patients without to group C-.</p> <p>Results</p> <p>Follow-up was possible in 60 patients (C+ 6.7 ± 5.6 M/C- 5.0 ± 2.8 M). Humeral head necrosis occurred in 6 (C+, 15.4%) and 3 (C-, 14.3%) cases. Cut-out of the proximal screws was observed in 3 (C+, 7.7%) and 1 (C-, 4.8%) cases. In each group, 1 patient showed delayed union. Implant failure or lesions of the axillary nerve were not observed. In 44 patients, true AP and Neer views were available to measure the head-plate distance. There was a significant loss of reduction in group C- (2.56 ± 2.65 mm) compared to C+ (0.77 ± 1.44 mm; p = 0.01).</p> <p>Conclusions</p> <p>The placement of calcar screws in the angular stable plate fixation of proximal humeral fractures is associated with less secondary loss of reduction by providing inferomedial support. An increased risk for complications could not be shown.</p>http://www.josr-online.com/content/6/1/50Proximal humerusfracturelocked screwlocking plate |
| spellingShingle | Simmen Hans-Peter Wanner Guido A Ossendorf Christian Osterhoff Georg Werner Clément M The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study Journal of Orthopaedic Surgery and Research Proximal humerus fracture locked screw locking plate |
| title | The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study |
| title_full | The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study |
| title_fullStr | The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study |
| title_full_unstemmed | The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study |
| title_short | The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study |
| title_sort | calcar screw in angular stable plate fixation of proximal humeral fractures a case study |
| topic | Proximal humerus fracture locked screw locking plate |
| url | http://www.josr-online.com/content/6/1/50 |
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