Article viewed 105 times

18 Jul 2024
Add to Bookmarks


 

Displaced Surgical Neck Fracture with minimally invasive approach

Score and Comment on this Case

Select a Score out of 10, and add a comment in the field below

Respectfully consider international variabilty in surgical technique and implants when commenting.
Protected by reCAPTCHA - Privacy and Terms


Clinical Details

Clinical and radiological findings:  A 65-year-old female sustained a fall from standing height, resulting in a displaced surgical neck fracture of the humerus with medial displacement of the diaphysis and a non-displaced fracture of the greater tuberosity. Initial radiographs confirmed the fracture pattern, and neurovascular examination was unremarkable.

Preoperative Plan

Planning remarks:  The planned surgical approach involved a minimally invasive technique to reduce the surgical neck fracture and stabilize it using a proximal humeral locking plate. The greater tuberosity fracture, being non-displaced, did not require direct intervention.

Surgical Discussion

Patient positioning:  The patient was positioned in a beach chair position with a C-arm fluoroscope for intraoperative imaging.

Anatomical surgical approach:  A minimally invasive anterolateral approach was utilized. A small incision was made over the deltoid muscle, and subdeltoid dissection was performed to expose the proximal humerus. The fracture site was visualized, and reduction was achieved using percutaneous techniques.

Operative remarks: 

Proximal screws were inserted into the head of the humerus (Fila A) and secured with Kirschner wires to maintain temporary stability. Once the plate and proximal screws were confirmed to be in adequate position via fluoroscopy, the medial displacement of the diaphysis was reduced using a cortical screw. Final fixation was completed by inserting diaphyseal screws.

Postoperative protocol:   Postoperatively, the patient was advised to wear a shoulder immobilizer during the day for 4 weeks. Passive range of motion exercises were initiated immediately, progressing to active-assisted exercises at 6 weeks post-surgery. Full weight-bearing and unrestricted activities were allowed by 12 weeks postoperatively.

Follow up:   Not specified

Orthopaedic implants used:   Proximal humeral locking plate, Kirschner wires, cortical screw

Search for Related Literature

Powered by OrthoSearch - The British Editorial Society of Bone & Joint Surgery


#

LUIS LEONCIO TEMOCHE DIAZ
  • Peru , Lima
  • Area of Specialty - Shoulder
  • Position - Specialist Consultant
#
Industry Sponsership

contact us for advertising opportunities


Peer Review Score

Average Score based on 0 reviews

Catalogue Index