Application of the Targon PH Long Nail in Storey Fractures and Metaphyseal Fractures of the Proximal Humerus


Authors: J. Šrám;  R. Lukáš;  M. Křivohlávek;  S. Taller
Authors‘ workplace: Traumacentrum Krajské nemocnice Liberec, primář: MUDr. R. Lukáš, Ph. D.
Published in: Rozhl. Chir., 2007, roč. 86, č. 5, s. 254-262.
Category: Monothematic special - Original

Overview

Storey and proximal metadiaphyseal humeral fractures are serious injuries , affecting patients of all age cathegories, however, elderly patients are affected more often. Conservative treatment results in a long-term immobilisation of the extremity, restricts ventilation and reduces the comfort. Former implants did not meet requirements for a stable osteosynthesis and hampered early rehabilitation. The Targon PH long nail (Aesculap, Tuttlingen, SRN) combines advantages of intramedullary fixation within the whole length of the medullary cavity with the use of angle-stable screws in the proximal fixation storey, which extends chances for a reliable osteosynthesis also to the proximal fifth of the humerus. The procedure’s prons include the miniinvasive character of the procedure and the possibility of adequate early rehabilitation. The authors assess a patient group of 23 subjects, including 14 females and 9 males, operated in the Traumacentrum of the Liberec Regional Hospital from January 2004 to December 2005. The final functional results assessment could be performed in 20 patients (87%), 13 females and 3 males, aged 65.3 years, on average. The minimal follow-up period lasted 12 months and the result was evaluated using the Constant-Murley score.

Key words:
intramedullary pinning – Targon PH long – metaphyseal fractures – storey fractures


Sources

1. Adedapo, A. O., Ikpeme, J. The results of internal fixation of three- and four part proximal humeral fractures with the Polarus nail. Injury, 2001, roč. 32, č. 2, s. 115–121.

2. Attmanspacher, W., Thaler, K. H., Stedtfeld, H. W. Winkelstabile intramedularer osteosyntese proximaler humerus– und humeruskopffrakturen mit dem targon PH – Erste Ergebnisse

3. Bartoníček, J., Stehlík, J., Dlouhý, M. Osteosyntéza zlomenin proximálního konce humeru modifikovanou dlahou. 1. část: Operační technika. Acta Chir. orthop. Traum. čech., 1995, roč. 62, č. 4, s. 207–220.

4. Bequin, L., Adam, P., Vanel, O. Indications and failure of locked nailing with a sef- locking screw for proximal fractures of the humerus: Prospective study with 50 Telegraph Nails. J. Bone Joint Surg. Br., 2004, roč. 86, suppl. I, s. 86.

5. Blum, J., Hessmann, M. H., Rommens, P. M. Treatment of proximal metaphyseal fractures of the humerus with interlocked nailing and spiral blade – early experience with a new implant system. Akt Traumatol., 2003, roč. 33, č. 1, s. 7–13.

6. Bernard, J., Charalambides, C., Aderinto, J., Mok, D. Early failure of intramedullary nailing for proximal humeral fractures. Injury, 2000, roč. 31, č. 10, s. 789–792.

7. Cumy, C. H., Iirrazi, M., Neyton, L., Berrpchi, A., Beau, P. Telegraph nail used for internal fixation of proximal humerus fracture. Eur. J. Orthop. Surg. Traumatol., 2000, roč. 10, s. 21–26.

8. Ehlinger, M., Chiffolot, X., Cognet, J. M., Le Ciniat, Y., Dagner, E., Simon, P. Centromedullary nailing for humerus fractures: Preliminary results in 45 cases with targon nail. J. Bone Joint Surg. Br., Orthopedic Proceedings, Suppl. II, roč. 87 – B, s. 110.

9. Eissele, R., Kinzl, L. Nailing of articular and extraarticular fractures of the head of the humerus. Osteo Trauma Care, 2002, roč. 10, s. S1–S4.

10. Frič, V., Pazdírek, P., Bartoníček, J. Nepředvrtané zajištěné nitrodřeňové hřebování zlomenin humeru – základní hodnocení souboru. Acta Chir. orthop. Traum. čech., 2001, roč. 68, č. 6, s. 345–356.

11. Hessmann M. H., Blum J., Hofmann A., Kuchle R., Rommens P. M. Internal Fixation of Proximal Humeral Fractures: Current Concepts. Europ. J. Trauma, 2003, roč. 29, s. 253–261.

12. Lill, H., Hepp, P., Hoffmann, J. E., Laborowitcz, J., Korner, J., Josten, Ch., Duda, G. Neue implantate zur stabilisierung proximal humerusfrakturen. Eine vergleichende in vitro studie osteosyntese international. 2001, roč. 9, s. 85–93.

13. Linn, J., Hou, S.-M., Inove, N., Chao, E., Hang, Y.-S. Anatomic considerations of locked humeral nailing. Clin. Orthop. relat. Res., 1999, č. 368, s. 247–254.

14. Linn J. Effectiveness of locked nailing for displaced three – part proximal humeral fractures. J. Trauma, 2006, roč. 61, č. 2, s. 363–374.

15. Kentel, M., Lewczyk, L., Wodzislawski, W., Tokarczuk, K., Homik, J. Non-operative treatment of proximal and middle third of the humerus fractures. J. Bone Joint Surg. Br., 2004, roč. 86-B, Suppl. III.

16. Křivohlávek, M., Lukáš, R., Taller, S., Šrám, J. Použití úhlově stabilní dlahy Philos u zlomenin proximálního humeru. Úraz. Chir., 2005, roč. 13, č. 2, s. 52–59.

17. Linhart, W.,Grossterlinden, L., Hassunizadeh, B., Janssen, A., Sommerfeldt, D. W., Rueger, J. M. A new approach to operative treatment of proximal humeral fractures: Intramedullary nailing with fixed-angle locking screws. Osteo Trauma Care, 2002, roč. 10, s. S83–S85.

18. Lucas, P., Beano, A.,Cobo, J., Ramon y Cajal, H. The polarus nail as treatment of neer 3 and 4 proximal humerus fracture. J. Bone Joint Surg. Br., 2004, roč. 86-B, Suppl. III.

19. Mathews J., Lobenhoffer P. Results of intramedullary nailing of unstable proximal humeral fractures in geriatric patients with a new antegrade nail system. Unfallchirurg, 2004, roč. 107, s. 372–380.

20. Mittlmeirt, W. F., Stedtfeld, H. W., Eweret, A., Beck, M., Frossch, B., Gadl, G. Stabilisation of proximal humeral fractures with an angular an sliding stable antegrade locking nail (Targon PH). J. Bone Joint Surg., 2003, roč. 85, s. 136–146.

21. Moran, M. C. Distal interlocking during intramedullary nailing of the humerus. Clin. Orthop. relat. Res., 1995, č. 317, s. 215–218.

22. Naraen, A., Faraj, A. A., Livesley, P. J., Hambridge, J. E. A preliminary clinical experience with polarus nail for proximal humeral fractures.A pilot study on ten patients. Eur. J. Orthop. Surg. Traumatol., 2001, roč.11, s. 191–193.

23. Rajasekhar, C., Ray, P. S., Bhamra, M. S. Fixation of proximal humeral fractures with the polarus nail. J. Shoulder Elbow Surg., 2001, s. 7–10.

24. Sosna, A., Čech, O. Operační přístupy ke skeletu pohybového aparátu. Praha: Avicenum, 1987. s. 30–33.

Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account