Article viewed 289 times

18 Mar 2024
Add to Bookmarks


 

Osteosynthesis of Valgus Proximal Humerus Fracture Impacted in Three Fragments

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 37-year-old man, a dentist by profession, suffered a fall while running, presenting pain in his right shoulder. Normal neurovascular examination. X-rays reveal a valgus impacted fracture in three fragments with displacement of the greater tuberosity and valgus impaction of the humeral head. AO/OTA rating: 11-B2.

Preoperative Plan

Planning remarks:  Osteosynthesis with a locked plate for the proximal humerus is indicated. The preoperative plan includes a deltopectoral approach, with opening of the rotator interval to allow reduction of the impacted humeral head fragment, followed by synthesis of both tuberosities with sutures and fixation with a proximal humerus plate.

Surgical Discussion

Patient positioning:  Patient in supine position.

Anatomical surgical approach:  Deltopectoral approach starting at the lateral border of the pectoralis major muscle extending distally towards the arm. A subcutaneous dissection is performed and the interval between the deltoid and pectoralis major is identified. The rotator interval is opened to access and reduce the impacted humeral head fragment.

Operative remarks: 

During the operation, adequate reduction of the impacted humeral head fragment was achieved by opening the rotator interval. The tuberosities were synthesized with sutures and the fracture was subsequently fixed with a proximal humerus plate. Closure of the rotator interval was performed with simple knots to finish the procedure.

Postoperative protocol:   Protocolo de rehabilitación postoperatoria no especificado.

Follow up:   Postoperative control after 3 months shows complete consolidation of the fracture.

Orthopaedic implants used:   Locked plate for proximal humerus.

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