Preview

Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)

Advanced search

Clinical variant of the method of osteosynthesis of the neck of the humerus against the background of osteoporosis

https://doi.org/10.20340/vmi-rvz.2021.6.CASE.1

Abstract

The article presents an observation of the successful treatment of a patient with a fracture of the surgical neck of the right humerus against the background of osteoporotic lesions of the bone skeleton. This patient was initially underwent osteosynthesis with a titanium T-plate and screws, however, 2 weeks later, the metal structure migrated and the cancellous substance of the humerus head was severely destroyed, which made it difficult to carry out repeated resynthesis. We have proposed and tested a new method of osteosynthesis of fractures of the surgical neck of the shoulder using a titanium plate and a cerclage loop. The presented clinical observation demonstrates the feasibility of performing osteosynthesis according to our proposed method in patients with severe osteoporosis, when other methods of osteosynthesis are ineffective, and endoprosthetics of the humerus head is unavailable due to the burdened somatic status of the patient and the inaccessibility of this operation in small hospitals in the country.

About the Authors

O. N. Yamshchikov
Derzhavin Tambov State University, Medical Institute; Kotovsk City Clinical Hospital
Russian Federation

Tambov; Kotovsk 


Competing Interests:

The authors declare no competing interests.



S. A. Emelyanov
Derzhavin Tambov State University, Medical Institute; Kotovsk City Clinical Hospital
Russian Federation

Tambov; Kotovsk 


Competing Interests:

The authors declare no competing interests.



E. A. Kolobova
Derzhavin Tambov State University, Medical Institute
Russian Federation

Tambov


Competing Interests:

The authors declare no competing interests.



A. V. Grishin
Archbishop Luke Tambov City Clinical Hospital
Russian Federation

Tambov


Competing Interests:

The authors declare no competing interests.



P. M. Teplyakov
Derzhavin Tambov State University, Medical Institute; Kotovsk City Clinical Hospital
Russian Federation

Tambov; Kotovsk 


Competing Interests:

The authors declare no competing interests.



E. A. Shagina
Derzhavin Tambov State University, Medical Institute
Russian Federation

Tambov


Competing Interests:

The authors declare no competing interests.



References

1. Baron J.A., Barrett J.A., Karagas M.R. The epidemiology of peripheral fractures. Bone. 1996;18,Suppl. 3: 209-213. https://doi.org/10.1016/8756-3282(95)00504-8

2. Azizov M.Zh., Abdulkhakov N.T., Kodirov M.F., Zhurakulov Sh.A. The choice of the method of osteosynthesis in the surgical treatment of fractures of the proximal humerus. The genius of orthopedics. 2011;3:23-27. (In Russ).

3. Vainshtein V.G. Treatment of closed intra-articular fractures and dislocations of the extremities. St. Petersburg: Medicine. 1973. S. 39-43. (In Russ).

4. Rangan A, Handoll H, Brealey S, Jefferson L, Keding A, Martin BC. et al. Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial. JAMA. 2015 Mar 10;313(10):1037-47. https://doi.org/10.1001/jama.2015.1629 PMID: 25756440

5. Gavrilov I.I., Brysuk G.P., Gaiduk M.V., Galyan A.V., Gavrilov I.I. (Jr.) Osteosynthesis of fractures of the proximal humerus with plates with angular stability. Injury. 2011;3:30-33. (In Russ).

6. Ruedi T.P., Murphy W.M. AO Principles of Fracture Managent. Thieme. 2001;274-293. https://doi.org/10.1308/003588409X432419f

7. Kotelnikov G.P., Mironov S.P., Miroshnichenko V.F. Traumatology and Orthopedics. Moscow: GEOTAR-Media. 2009.400 s. (In Russ).

8. Azizov M. Zh. Abdulkhakov N.T., Kodirov M.F., Zhurakulov Sh.A. The choice of the method of osteosynthesis in the surgical treatment of fractures of the proximal humerus. The genius of orthopedics. 2011;3:5. (In Russ).

9. Makarova S.I. Vorobiev A.V. The choice of the method of osteosynthesis in the surgical treatment of fractures of the proximal humerus. Kazan Medical Journal. 2010;91(2):197-204. (In Russ).

10. Shagdurov V.A., Rinchinov R.D., Gubar E.A. Method of osteosynthesis of the surgical neck of the humerus in the elderly. Siberian Medical Journal. 2016;4:31-33. (In Russ).

11. Lazarev A.F., Solod E.I., Nikolaev V.M. Surgical treatment of the surgical neck of the humerus with strained Y-wires: clinical guidelines (S42.2). Central Research Institute of Traumatology and Orthopedics named after N.N. Priorov Roszdrav. Moscow. 2013.13 p. (In Russ).

12. Launonen A.P., Lepola T., Flinkkila T. Treatment of proximal humerus fractures in the elderly: a systemic review of 409 patients. ActaOrtopedica. 2015;86(3):280–285. https://doi.org/10.3109/17453674.2014.999299

13. Treatment of fractures of the proximal humerus. Clinical guidelines. Saratov NIITO. Saratov, 2013. (In Russ).

14. Wanner GA, Wanner-Schmid E, Romero J, Hersche O, von Smekal A, Trentz O. et al. Internal fixation of displaced proximal humeral fractures with two one-third tubular plates. J Trauma. 2003;54(3):536-544. https://doi.org/10.1097/01.TA.0000052365.96538.42 PMID: 12634535.

15. Korzh N.A., Prozorovsky D.V., Staude V.A. Postoperative rehabilitation of patients with injuries of the proximal humerus. Orthopedics, traumatology and prosthetics. 2001;4:67-79. (In Russ).

16. Wijgman AJ, Roolker W, Patt TW, Raaymakers EL, Marti RK. Open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus. J Bone Joint Surg Am. 2002;84(11):1919-1925 PMID: 12429749.

17. Mighell M. A., Kolm G. P., Collinge C. A., Frankle M. A. Outcomes of hemiarthroplasty for fractures of the proximal humerus. J. Shoulder. Elbow. Surg. 2003;12:569-577. https://doi.org/10.1016/s1058-2746(03)00213-1 PMID: 14671521.

18. Zyto K., Wallace W.A. Frostick S.P., Preston B.J. Outcome after hemiarthroplasty for three- and four-part fractures of the proximal humerus. J. Shoulder Elbow Surg. 1998;7:85-89. https://doi.org/10.1016/s1058-2746(98)90215-4 PMID: 9593083.

19. Liu k., Liu P.C., Liu R. Advantage of minimally invasive lateral approach relative to conventional deltopectoral approach for treatment proximal humerus fractures. Med. Sci. Monit. 2015;21:496-504. https://doi.org/10.12659/MSM.893323 PMID: 25682320; PMCID: PMC4335575.

20. Yamshchikov O.N., Emelyanov S.A., Kolobova E.A. Method of osteosynthesis of the humeral neck. RF patent No. 2749296, IPC A61B 17/56, A61B 17/58. 03/27/2011 (In Russ).


Supplementary files

Review

For citations:


Yamshchikov O.N., Emelyanov S.A., Kolobova E.A., Grishin A.V., Teplyakov P.M., Shagina E.A. Clinical variant of the method of osteosynthesis of the neck of the humerus against the background of osteoporosis. Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2021;(6):71-78. (In Russ.) https://doi.org/10.20340/vmi-rvz.2021.6.CASE.1

Views: 523


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2226-762X (Print)
ISSN 2782-1579 (Online)