Prior to joining Rothman Orthopaedic Institute, she worked as an emergency trauma center physician assistant at a local teaching hospital. Mila currently works with Dr.
Nonunion is seen only in up to 5. According to the systematic review of patients treated with a locking plate, Thanasas confirmed a high incidence of complications. Osteonecrosis occurred in 7. Analysis of these complications shows that most result from surgical mistakes and are therefore avoidable.
This is true for a wrong placement of the plate, especially a too high position resulting in an impingement, and for the primary intraarticular perforation of the screws.
To decrease these mistakes, it is recommended to use a supine position, placing the shoulder on small shoulder supports to allow a precise intraoperative X-ray control in two perpendicular views without moving the arm. Nevertheless, a meta-analysis published by Lanting in that included 66 studies and 2, fractures demonstrated that angularly stable plates seem to be favorable to nails in three- and four-part fractures [ 24 ].
Varus displaced humeral head four-part fractures, especially in combination with a medial comminution, are challenging, even today. In these cases, it is advisable to reduce the proximal humerus anatomically and to restore the calcar as precisely as possible. In cases of a medial comminution, implantation of an intramedullary fibular graft is shown to be beneficial.
Augmentation with bone substitutes is disappointing because they do not integrate and are not able to prevent a secondary varus collapse. Krappinger and colleagues determined several prognostic factors predicting a failure of plate osteosynthesis.
The risk of failure highly increases in the presence of two or more risk factors [.4 NCB® Proximal Humerus System – Surgical Technique Introduction NCB Proximal Humerus Osteosynthesis Plate Solution for Proximal Humerus Fractures The NCB-PH (Non-Contact Bridging for the Proximal Humerus) system is an optimal solution for the treatment of.
Isolated greater tuberosity fractures make up a small subset of proximal humerus fractures. We conducted a study to evaluate the radiologic and clinical outcomes of patients who underwent a novel use of plate osteosynthesis in the treatment of displaced greater tuberosity fractures.
Minimally invasive plate osteosynthesis in the treatment of proximal humeral fracture techniques and outcomes of those patients with proximal humeral shaft fractures treated by metaphyseal locking. (SBQ12TR.9) A year-old male is involved in a motor vehicle accident and presents with the closed orthopedic injuries shown in Figures A and B.
He is also noted to have a grade 1 splenic laceration and lung contusion.
He is cleared by the trauma team, and undergoes early total care with reamed femoral and tibial nailing. Mila is a board certified Physician Assistant who graduated from the Drexel Hahnemann Physician Assistant Program where she received her Masters of Health Science degree in .
Proximal humeral fractures account for about 5% of all extremity fractures and 70% of patients are at least 70 years of age (11). The prevalence of female gender ran-ges between 73 and 85% (4,11). A year-old women with a life expectancy of 81 years has an estimated resi-dual lifetime risk of 8% of fracturing her proximal hume-rus (30).