J Korean Fract Soc.  2007 Jan;20(1):45-52. 10.12671/jkfs.2007.20.1.45.

Open Intramedullary Nail with Tension Band Sutures & Lock Sutures on Proximal Humeral Three-part Fracture

• Park JO
• Park JY
• Lee ST
• Park HK

• KMID: 2294378
• DOI: http://doi.org/10.12671/jkfs.2007.20.1.45

Abstract

PURPOSE
To evaluate the results according to the difference of age and bone mineral density (BMD) of the surgical treatments using open intramedullary nail with tension sutures and lock suture on proximal humeral three part fracture.
MATERIALS AND METHODS
30 patients treated by open intramedullary nail with tension band and lock suture technique on proximal humeral fractures were reviewed. After treatment, average follow up periods was 50 months (range; 17~143 month). Postoperative clinical outcome was evaluated using ASES functional score, Neer score and constant score.
RESULTS
Bony union were obtained all except one case. Range of motion, mean forward elevation was 142°, mean external rotation was 56°, mean external rotation at 90° abduction was 68°. Average pain score of visual analog scale was 1.5. Average functional score of American Shoulder and Elbow Society was 86. Average Neer score was 89. Constant score was 85. Pain and functional score of group I were better than those of group, however, there was no statistically significant difference (p>0.05). In the comparison between group III and group IV, the results were same (p>0.05).
CONCLUSION
The patients treated using open intramedullary nailing, tension band and lock suture could enable early ROM exercise and show good clinical results. This treatment method will be useful in old age osteoprorotic patients.

Keyword

Proximal humerus; Three part fracture; Intramedullary nail; Tension band suture

MeSH Terms

Bone Density
Elbow
Follow-Up Studies
Fracture Fixation, Intramedullary
Humans
Methods
Range of Motion, Articular
Shoulder
Shoulder Fractures
Suture Techniques
Sutures*
Visual Analog Scale

Figure

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  Fig. 1 The preoperative anteroposterior (A), axillary lateral (B) radiograph of 69-year old female after slip down injury. BMD is t-score -2.7.

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  Fig. 2 Immediate postoperative radiographs, anteroposterior (A) and axillary lateral (B) show well fixed fragments using intramedullay nailing.

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  Fig. 3 Radiographs, anteroposterior (A) and axillary lateral (B) taken at 2 years after operation show good bone union.

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  Fig. 4 The preoperative anteroposterior (A) and lateral (B) radiograph of 73-year old female after slip down injury. BMD is t-score -3.6.

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  Fig. 5 Radiographs, anteroposterior (A) and axillary lateral (B) taken at 2 years after operation show good bone union.

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