RESUMEN
OBJECTIVE: To appraise the value of clinical treatment of percutaneous reduction and fixation of osteoporotic fractures for the proximal humerus in a geriatric population. METHODS: Postoperation complication, mortality in hospital and within the first three months postoperation, operation time, blood transfusion requirement, the functional outcome of the shoulder had been analysed and observed in 37 cases for open and closed fixation. RESULTS: Closed reduction provided the benefit of obtaining and holding adequate reduction without the soft-tissue dissection of open reduction and internal fixation. The general complication and mortality in the first three months postoperation in the open reduction and internal fixation cases were more severe than the percutaneous cases. CONCLUSIONS: Open operation increases the risk of the geriatric population with osteoporotic proximal humerus fracture; percutaneous reduction and fixation may be preferable.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas del Hombro/cirugía , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos , Osteoporosis/complicaciones , Complicaciones Posoperatorias/prevención & control , Fracturas del Hombro/etiología , Resultado del TratamientoRESUMEN
OBJECTIVE: To value the use of an injectable minimally invasive calcium sulfate cement for displaced tibial plateau fractures. METHODS: Thirteen patients with lateral tibial plateau fractures treated with internal fixation and bone grafting were matched with 13 patients treated using internal fixation and an injectable calcium sulfate cement. The clinical data were retrospectively analyzed. All patients were followed up for a minimum of one year. The peri-operative complication, quality of reduction, maintenance of reduction, function assessment and development of post-traumatic osteoarthritis was compared in both groups. RESULTS: Ten patients in the internal fixation and bone graft group had excellent anatomical reductions as judged on immediate post-operative radiographs but some loss of reduction on follow-up at one year was observed in 8 of the 13 (61%) cases. Twelve patients from the MIIG group had an excellent reduction on immediate post-operative radiographs but 3 (23%)demonstrated some loss of reduction of the plateau at one year follow-up (P < 0.05). CONCLUSIONS: The use of MIIG and internal fixation is associated with more favourable clinical results than conventional treatment with internal fixation and bone grafting for lateral tibial plateau fractures.