Displaced proximal humeral fractures in skeletally immature patients: functional outcomes of surgical treatment.

Autor: Vergara, Alberto Daniel Navarro, Fretes, Alberto Navarro
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Zdroj: European Journal of Orthopaedic Surgery & Traumatology; Oct2024, Vol. 34 Issue 7, p3759-3766, 8p
Abstrakt: Purpose: To report the functional results of our experience and to describe intraoperative findings and complications due to the techniques used in our service. Methods: From January 2018 to December 2022, 27 Pediatric patients aged from 8 to 16 years underwent surgery to treat proximal humerus fractures. Their demographic characteristics were evaluated, as well as their clinical characteristics on admission, type of reduction (closed/open), presence of interposition in open reductions, type of implant, complications, and functional range of movement according to two shoulder functional scores. Results: Mean age was 11.2 years (8–15), there was a predominance of males, who accounted for 70% of the cases, and sports accidents were the cause of injury in 44% of the cases. Anatomical location was balanced between patients, including 55% of physeal fractures and 45% of metaphyseal ones. Overall, 81.5% of patients required open reduction to achieve axis correction, and that 55.5% of fractures were fixed with Kirschner wires, and 44, 4% with elastic titanium nails. Mean QuickDASH score was 0.58 (0–1.7), and Constant score was 9 (3–24). There were no major complications, but 27% of cases subjected to open reduction presented a hypertrophic scar. Conclusion: Surgical treatment of severely displaced proximal humerus fractures is successful, both with closed and open reduction; type of implant does not play a key role and should be selected based on the characteristics of each case. Surgical training should prevail at the time of decision-making. When these recommendations are followed, results can be excellent and sequelae are infrequent. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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