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Fixation of complex proximal humeral fractures in elderly patients with a locking plate： A retrospective analysis of radiographic and clinical outcome and complications

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Chinese Journal of Traumatology 2016年第3期19卷 156-159页

作者： fabio rodia Emmanouil Theodorakis Georgios Touloupakis Angelo Ventura Department of Orthopaedics and Traumatology CFO Hospital "A Alesini" Roma 00185 Italy Department of Orthopaedics and Traurnatology Aurelia Hospital Roma 00185 Italy

Purpose： The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial. Good clinical results have been reported by plating these fractures as well as a high rate of complications. Our retrospective study aims to evaluate clinical recovery and complications using the S3 locking plate in elderly patients. Methods： Fifty-one patients older than 65 years of age, with a complex proximal humeral fracture type B or C （AO classification system）, were included. Patients have been followed up for a minimum of 12 months. We assessed callus formation, radiological results, clinical outcome （according to the Constant Shoulder Score System） and complications. Any difference in the clinical recovery among the 2 types of fracture pattern （B and C） was investigated. Results： The mean time of fracture healing was 12.4 weeks. The mean Constant score at 3, 6 and 12 months was 68, 73 and 75 respectively. No statistically significant difference in the clinical outcome was observed between the 13 and C fracture patterns （p 〉 0.05）. We noticed an overall of 5 complications （9.8%）. There was no need to revision any of the implants. Conclusion： Anatomic reduction and proper plate positioning are essential for minimizing implant- related complications. In our experience the S3 angular stability system offers a proper osteosyntesis and a ~ood clinical recovery with a low rate of complications.

关键词： Shoulder fracturesBone platesHumerusAged

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Missed posterior shoulder dislocation and McLaughlin lesion after an electrocution accident

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Chinese Journal of Traumatology 2012年第6期15卷 376-378页

作者： fabio rodia Angelo Ventura Georgios Touloupakis Emmanouil Theodorakis Marco Ceretti CTO Trauma and Orthopedic Hospital RomeItaly

Posterior shoulder dislocation is a rare event that may occur after a direct trauma, an epileptic seizure, electric shock or electroconvulsive therapy. In more than 50% of the cases, posterior dislocations are missed on initial evaluation and often misdiagnosed as frozen shoul- ders with unfortunate consequences. We present the case of a missed posterior suhluxation and reverse Hill Sachs lesion （McLaughlin lesion） in a 40-year-old woman caused by anelectric shock of 240 V. The patient underwent sur- gery in our institute two weeks after the injury. The humeralhead was reduced and the reverse Hill Sachs lesion was filled by demineralized bone matrix allograft with osteoinductive factors. Tendons were repaired and a temporaneous artrodesis was performed. At the final follow up of 12 months, we obtained a Costant Score of 93 and the patient returned to her previous daily activities.

关键词： Shoulder dislocation Electric injuries Bone matrix

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