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  • 18 — 9 (47) 2022 — A.P. Alimov, S.Y. Yusupov, S.K. Hakimov, MINIMALLY INVASIVE SURGICAL METHOD FOR FRACTURES OF THE PROXIMAL HUMERUS

18 — 9 (47) 2022 — A.P. Alimov, S.Y. Yusupov, S.K. Hakimov, MINIMALLY INVASIVE SURGICAL METHOD FOR FRACTURES OF THE PROXIMAL HUMERUS

MINIMALLY INVASIVE SURGICAL METHOD FOR FRACTURES OF THE PROXIMAL HUMERUS

A.P. Alimov, Republican Specialized Scientific and Practical Medical Center of Traumatology and Orthopedics Ministry of Health of the Republic of Uzbekistan. Bukhara State Medical Institute. Bukhara Branch of the Republican Scientific Center for Emergency Medical Aid.

S.Y. Yusupov, Republican Specialized Scientific and Practical Medical Center of Traumatology and Orthopedics Ministry of Health of the Republic of Uzbekistan. Bukhara State Medical Institute. Bukhara Branch of the Republican Scientific Center for Emergency Medical Aid.

S.K. Hakimov, Republican Specialized Scientific and Practical Medical Center of Traumatology and Orthopedics Ministry of Health of the Republic of Uzbekistan. Bukhara State Medical Institute. Bukhara Branch of the Republican Scientific Center for Emergency Medical Aid.

Resume

This study shows the improvement of treatment outcomes by developing a minimally invasive surgical technique for fractures of the proximal humerus.

The material of the study included 40 patients with fractures of the proximal humerus. In 15 patients, varus mixing of bone fragments was noted. Among the patients, 15 were men and 25 women. The duration of the injury averaged 5.8±1.8 days. The clinic has developed a technique of extramedullary osteosynthesis using a minimally invasive plate and an external distraction apparatus in order to minimize the trauma of surgical intervention and is actively used in patients with fractures of the proximal humerus.

In patients with fractures of the proximal humerus, the results of treatment were assessed using the 100-point scale Neer C.S. and, accordingly, among all 40 patients, 37 (92.5%) patients had good, 2 (5%) satisfactory, and the remaining 1 (2.5%) patients had unsatisfactory postoperative results, which were associated with the presence of pain syndrome, amplitude limitation movement up to 15 degrees and signs of arthrosis in the shoulder joint on the control radiograph.

According to the conclusion of the authors, the proposed minimally invasive surgical technique for fractures of the proximal humerus made it possible to carry out low-traumatic reposition and stable fixation of bone fragments.

The proposed minimally invasive surgical technique helps to increase the proportion of the best results to 97.5%, as well as improve the quality of life of patients.

Key words: shoulder, proximal, minimally invasive, osteosynthesis.

First page

101

Last page

108

For citation: A.P. Alimov, S.Y. Yusupov, S.K. Hakimov, MINIMALLY INVASIVE SURGICAL METHOD FOR FRACTURES OF THE PROXIMAL HUMERUS //New Day in Medicine 9 (47)2022 101 – 108 https://l.clck.bar/e420f

LIST OF REFERENCES:

  1. Keener J. D., Parsons B. O., Flatow E. L., Rogers K., Williams G. R., Galatz L. M. Outcomes after percutaneous reduction and fixation of proximal humeral fractures. // J. Shoulder Elbow Surg, 2007; 6: 330–338.
  2. Loskutov A. E., et al. Differencirovannye podhody k operativnomu lecheniyu bolnyh s povrezhdeniyami proksimalnogo otdela plechevoi kosti [Different approaches to surgical treatment of patients with damages of proximal humerus]. Ortopediya, traumotologiya i protezirovanie [Orthopaedics, traumatology and prosthetics], 2007; 1: 33–38.
  3. Sun J.C., et al. Treatment of three- and four-part proximal humeral fractures with locking proximal humerus plate. // Eur. J. Orthop. Surg. Traumatol, 2013; 23(6): 699-704.
  4. Rothstock S., et al. Biomechanical evaluation of two intramedullary nailing techniques with different locking options in a three-part fracture proximal humerus model. Clin. Biomech. Bristol, Avon, 2012; 27(7): 686-691.
  5. Den Hartog D., et al. Primary shoulder arthroplasty versus conservative treatment for comminuted proximal humeral fractures: a systematic literature review. // Open Orthop. J, 2010; 4: 87-92.
  6. Brunner A., et al. Minimally invasive percutaneous plating of proximal humeral shaft fractures with the Proximal Humerus Internal Locking System (PHILOS). // J. Shoulder Elbow Surg, 2012; 21(8): 1056-1063.
  7. Dilisio M.F., et al. Intramedullary nailing of the proximal humerus: evolution, technique, and results. // J Shoulder Elbow Surg, 2016; 25(5): 130-e138. doi: 10.1016/j.jse.2015.11.016.
  8. Zhu Y., Lu Y., Shen J., Zhang J., Jiang C. Locking intramedullary nails and locking plates in the treatment of two-part proximal humeral surgical neck fractures: a prospective randomized trial with a minimum of three years of follow-up. // J Bone Joint Surg Am, 2011; 93(2): 159-168. doi:10.2106/JBJS.J.00155.
  9. Gavaskar A.S., Karthik B.B., Tummala N.C., Srinivasan P., Gopalan H. Second generation locked plating for complex proximal humerus fractures in very elderly patients. Injury, 2016; 47(11): 2534-2538. doi:10.1016/j.injury.2016.08.010.
  10. Wong J., Newman J.M., Gruson K.I. Outcomes of intramedullary nailing for acute proximal humerus fractures: a systematic review. // J Orthop Traumatol, 2016; 17: 113–122.
  11. Magovern B., et al. Percutaneous fixation of proximal humerus fractures. Orthop Clin North Am, 2008; 39: 405–416.
  12. Yang K. H. Helical plate fixation for treatment of comminuted fractures of the proximal and middle one-third of the humerus // Injury, 2005; 36: 75–80.
  13. Martin C., Guillen M., Lopez G. Treatment of 2- and 3-part fractures of the proximal humerus using external fixation: a retrospective evaluation of 62 patients // Acta Orthop, 2006; 77: 275–278.

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