Surgical treatment of intra-articular fractures of the proximal humerus

Abstract

Background. The most severe category of fractures of the proximal humerus are  intra-articular injuries which are accompanied with humeral head ischemia caused by an injury and aggravated by surgical intervention. Due to frequent disruption of vascularization with subsequent necrosis of the humeral head, there is a need to stimulate reparative osteogenesis in intra-articular injuries to prevent ischemic changes in the humeral head. The aim of the study. To improve the results of surgical treatment of intra-articular fractures ofthe proximal humerus based on the development of a new osteosynthesis technique using non-free osteomuscular graft. Material and methods. We analyzed the results of treatment of 48patients with 11- C1 and 11-C2 intra-articular fractures of the proximal humerus, who had hospital treatment at the emergency department of traumatology of the Novosibirsk City Clinical Hospital No.  1 and were subsequently observed on an outpatient basis. An  analysis of literature data using search words was carried out in the PubMed and eLibrary databases. Results. According to the data obtained during the study, the functional and radiological results of the patients who were treated using the method of reparative stimulation with a non-free osteomuscular graft from the coracoid process are statistically significantly higher than the results of the control group. Conclusion. Using autoplasty with a non-free osteomuscular graft from the coracoid process improves the results and reduces the risk of developing post-traumatic aseptic necrosis of the humeral head.