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Favorable preliminary results reported with radiolucent implant for proximal humerus fracture treatment
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NEW YORK — Researchers of a retrospective review presented at the International Society for Fracture Repair Meeting, here, showed use of a novel, radiolucent carbon fiber plate for proximal humerus fractures resulted in anatomic or near anatomic reduction in most cases, and one case each of loss of tuberosity fixation and humeral head settling with secondary screw penetration.
“Our outcomes were positive,” David J. Hak, MD, MBA, FACS, of Denver, said during his presentation. “There were no postoperative infections. There was one patient who had loss of tuberosity fixation and failed to recover satisfactory motion. All the others had acceptable or good range of motion despite the severity of their injuries. This radiolucent carbon fiber plate permits more accurate assessment of the fracture reduction and allows you to follow fracture healing. The [plate’s] low modulus of elasticity may be beneficial in terms of achieving fracture union and may minimize settling with secondary screw penetration. You get a flexible implant, and our preliminary experience is favorable.”
David J. Hak
The study included 16 patients with 17 displaced proximal humerus fractures treated with open reduction and internal fixation using the carbon fiber plate. Three patients were lost to follow-up, and the remaining patients had an average follow-up of 6 months. Patients had an average age of 57 years.
The average operating time was 117 minutes, and the average fluoroscopy time was 81 seconds. According to Hak, surgeons reduced 15 fractures using a deltopectoral approach and two fractures were reduced using a deltoid split approach. An average of seven screws were placed in the humeral head and most plates were fixed with three bicortical screws. Calcium phosphate cement was injected in four cases.
“The reduction accuracy was determined to be anatomic or near anatomic in 14 cases, and there were three cases with either varus or extension malreduction,” Hak said. Radiographic results revealed no loss of fixation and no evidence of implant failure.
“One case had humeral head settling secondary to screw penetration that occurred in a 65-year-old woman with known osteoporosis,” Hak said. This fracture was also supplemented with calcium phosphate cement for humeral head fixation, he noted. – by Gina Brockenbrough, MA
Reference:
Hak DJ. Abstract #3. Presented at: International Society for Fracture Repair Meeting; May 12-17, 2014; New York.
Disclosure: Hak receives consulting fees or honoraria from RTI Biologics and Invibio, which makes the raw materials for the carbon fiber implants.