Technique of Open Reduction and Internal Fixation of Comminuted Proximal Humerus Fractures With Allograft Femoral Head Metaphyseal Reconstruction

Stephen A. Parada, Amun Makani, Monica J. Stadecker, Jon J.P. Warner

Research output: Contribution to journalArticle

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Abstract

Proximal humerus fractures are common injuries that can require operative treatment. Different operative techniques are available, but the hallmark of fixation for 3- and 4-part fractures is a locking-plate-and-screw construct. Despite advances in this technology, obtaining anatomical reduction and fracture union can be difficult, and complications (eg, need for revision) are not uncommon. These issues can be addressed by augmenting the fixation with an endosteally placed fibular allograft. Although biomechanical and clinical results have been good, the technique can lead to difficulties in future revision to arthroplasty, a common consequence of failed open reduction and internal fixation. The technique described, an alternative to placing a long endosteal bone graft, uses a trapezoidal, individually sized pedestal of allograft femoral head to facilitate the reduction and healing of the humeral head and tuberosity fragments in a displaced 3- or 4-part fracture of the proximal humerus. It can be easily incorporated with any plate-and-screw construct and does not necessitate placing more than 1 cm of bone into the humeral intramedullary canal, limiting the negative effects on any future revision to arthroplasty.

Original languageEnglish (US)
Pages (from-to)471-475
Number of pages5
JournalAmerican journal of orthopedics (Belle Mead, N.J.)
Volume44
Issue number10
StatePublished - Oct 1 2015

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Humerus
Thigh
Arthroplasty
Allografts
Humeral Head
Bone and Bones
Fracture Fixation
Technology
Transplants
Wounds and Injuries
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Technique of Open Reduction and Internal Fixation of Comminuted Proximal Humerus Fractures With Allograft Femoral Head Metaphyseal Reconstruction. / Parada, Stephen A.; Makani, Amun; Stadecker, Monica J.; Warner, Jon J.P.

In: American journal of orthopedics (Belle Mead, N.J.), Vol. 44, No. 10, 01.10.2015, p. 471-475.

Research output: Contribution to journalArticle

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