Humeral head replacement for four-part proximal humerus fractures.docVIP

 PAGE \* MERGEFORMAT 9 Humeral head replacement for four-part proximal humerus fractures Study: Canadian Bin WANG Yue Yuan Jian ZHANG Yao-ming Pang [Keywords:] complex proximal humeral fractures Complex proximal humerus fractures, particularly in the clinical treatment of four-part fractures is very difficult, such injuries are often older patients, with various degree of osteoporosis, surgical open reduction and internal fixation is difficult to obtain satisfactory results [1]. I Division from April 2003 to December 2007 using artificial humeral head replacement for four-part proximal humeral fractures in 18 cases, get better effect. 1 Materials and Methods 1.1 General Information The group of 18 patients, 7 males and 11 females, aged 48 to 79 years old, average 59.2 years old. According to Neer classification [2] are the four-part fractures. Fresh fractures in 16 cases, 2 cases of old fracture. Combined dislocation 5 cases, 4 cases of anterior dislocation, 1 case of posterior dislocation. 1.2 surgical patients supine position, shoulder padded, anesthesia after successful anterior medial approach to take, remove the exposed humeral head fractures after shoulder block, keep the muscles attached to a large and small nodules fracture blocks. According to the humerus marrow cavity size of the reamed, reamed to maintain 20 ~ 35 of posterior tilt, with the brachial two long head tendon tension to determine the height of implants and make marks. washed into the medullary cavity stopper, injection of bone cement, into the prosthesis, the humeral head maintained at 20 ~ 35 backward place. All prostheses were fixed with bone cement. into a rotator cuff tissue attached to the large and small nodules fractures fixed with silk thread to block off a small body and neck Drilling holes or attached to the proximal humerus (Figure 1 and 2). Check the joints are good and stable layer close the incision. Figure 1, four-part proximal humeral fractures of t