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

Jin-Oh Park; Jin-Young Park; Sung-Tae Lee; Hong-Keun Park

doi:10.12671/jkfs.2007.20.1.45

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Park, Park, Lee, and Park: Open Intramedullary Nail with Tension Band Sutures & Lock Sutures on Proximal Humeral Three-part Fracture

Original Article

Journal of the Korean Fracture Society 2007; 20(1): 45-52.

Published online: 14 June 2016

DOI: https://doi.org/10.12671/jkfs.2007.20.1.45

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

Jin-Oh Park, M.D., Jin-Young Park, M.D.^*, Sung-Tae Lee, M.D.^*, Hong-Keun Park, M.D.^*

Department of Orthopaedic Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

^*Department of Orthopaedic Surgery, Konkuk University College of Medicine, Seoul, Korea.

Address reprint requests to: Jin-Young Park, M.D. Department of Orthopaedic Surgery, Konkuk University Hospital, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea. Tel: 82-2-2030-5210, Fax: 82-2-2030-5009, drpark@chol.com

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 142degrees, 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.

Keywords: Proximal humerus, Three part fracture, Intramedullary nail, Tension band suture

Figures and Tables

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.

Fig. 2

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

Fig. 3

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

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.

Fig. 5

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

Table 1

Clinical data of patients with proximal humeral three-part fractures treated by open intramedullary nailing with tension-band and locking sutures

^*SN: Surgical neck, ^†GT: Greater tuberosity, ^‡Fx-D/L: Fracture-dislocation, ^§LT: Lesser tuberosity, ^∥FE: Forward elevation, ^¶ER: External rotation, ^**ERa: Abduction (90°)+external rotation, ^††IR: Internal rotation.

Table 2

Range of motion according to age

p>0.05.

Table 3

Clinical results of the proximal humeral fracture according to the age at the injury

p>0.05.

Table 4

Clinical results of the proximal humeral three-part fracture according to the bone mineral density

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