OSTEOSYTHESIS IN FRACTURE OF THE ANATOMICAL NECK OF THE HUMERUS

In our observation we identify three types of the fracture of the anatomical neck of humerus:

  • I-Type- the proximal fragment is represented as an isolated head without any linkage what so ever to the capsule of the joint;
  • II-Type-the line of the fracture passes through the medial surface of the metaphysic with the proximal fragment forming a wedge-shaped fracture edge or through the greater tuberosity with the fracture of its proximal part;
  • III-Type- fracture of the anatomical neck with an associated comminuted fracture of the proximal metaphyseal humeral bone.

In the I Type the fracture, the head of the humerus is presented as a free, avasculated and fragmented. In П and III Type, there are possibilities of the preservation of vascular linkages.

In any case, osteosynthesis of the fracture of the anatomical neck of the humerus is perform as autoplasty, in which the union of the fragment depends on the restoration of the regional blood supply, which in the other hand depends on the reduction and the stability of the osteosynthesis. Chosen method of osteosynthesis in an unsatisfactory close reduction defines the result of treatment.

Observation shows that, using our developed method of osteosynthesis (two parallel pins between which a screw is introduced) gives good stability of isolated head (I Type), permits early motion in the joint. Even still reliable are our develop method and device for osteosynthesis, most especially in fracture of the head and neck of the humerus. Type П fracture of the anatomical neck of the humerus is an indication for osteosynthesis with a loop of the figure of eight or our device.

Osteosynthesis of the Type III fracture is most appropriately perform using our method with a longer screw introduced through the sub-tuberosity region.

We treated 41 patients having different fractures of the anatomical neck of the humeral bone. Using our developed method of osteosynthesis permits our obtaining good results in all operated cases.

V.A. Babosha, Itaketo Ndaeyo Idongesit. 
Scientific and Research Institute of Traumatology and Orthopaedy, DSMU- Donetsk, Ukraine.

 

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