Percutaneous fixation of unstable proximal humeral fractures augmented with external Ilizarov cubes: a new simple technique

O. Metwally, Yehia Elbromboly
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Abstract

Purpose To present the management of unstable proximal humeral fractures with percutaneous pinning augmented by an external Ilizarov cubes in elderly patients with poor general condition. Patients and methods Between October 2021 and December 2021, 7 patients (mean age: 56.7, range 53–62) with three-part proximal humeral fracture with 2 or more co-morbidities were surgically managed by percutaneous pinning augmented by an external cube. Functional results were evaluated through measuring shoulder range of motion. Radiological evaluation was done by antero-posterior and lateral radiograms of the treated humerus. Results The patients were followed up for an average period of 6 months. The external cube and the pins were removed at about the 6 weeks mark. The average range of motion at the final follow up was Abduction 110°, forward flexion 140°, internal rotation 60°, external rotation 58°. All patients achieved full radiological union. Conclusion Percutaneous fixation of unstable humeral fractures is an effective method of treatment especially in elderly patients with multiple co-morbidities. Adding external Ilizarov cubes to the construct is an easy, affordable, and quick method of improving results and minimizing complications of early pin loosening that give the ability of early range of motion and rapid bone union.
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经皮固定术治疗不稳定肱骨近端骨折外置Ilizarov立方体:一种新的简单技术
目的介绍一般情况较差的老年患者经皮外钉加伊利扎罗夫立方体固定治疗不稳定肱骨近端骨折的方法。在2021年10月至2021年12月期间,7例伴有2种或更多合并症的肱骨近端三段式骨折患者(平均年龄:56.7岁,范围53-62岁)接受了经皮外固定钉增强手术治疗。通过测量肩关节活动度来评估功能结果。通过治疗肱骨的前后位和侧位x线片进行放射学评估。结果随访时间平均为6个月。大约6周时,取出外部立方体和针。最后随访时的平均活动范围为外展110°,前屈140°,内旋60°,外旋58°。所有患者放射学完全愈合。结论经皮内固定治疗不稳定肱骨骨折是一种有效的治疗方法,尤其适用于有多种合并症的老年患者。将外部Ilizarov立方体添加到结构中是一种简单,经济,快速的方法,可以改善结果并最大限度地减少早期针松动的并发症,从而提供早期活动范围和快速骨愈合的能力。
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