For complex and unstable fractures locking proximal. They are common in the older osteoporotic individuals secondary to low energy trauma such as a fall from standing but are also seen in younger patients after a high energy trauma such as a motor vehicle accident or fall from a height. The conventional sps small and basic fragment sets are standard plating. Proximal lateral tibial plate the axsos locking plate system is designed to treat periarticular or intraarticular fractures of the proximal humerus, distal femur, proximal tibia, and the distal tibia. The humeral sutureplate is an anatomically designed polyaxial locking plate and screw system designed for the treatment of proximal humeral fractures. Monoaxial locking plate system for treating proximal humerus fractures. Nov 17, 2019 a proximal humerus fracture occurs when the ball, of the ballandsocket shoulder joint, is broken.
Hemiarthroplastyorif proximal humerus fracture protocol general principles of rehabilitation for fractures treat the patient not the fracture move all joints that are not immobilized prevent disuse atrophy use gravity to assist in mobilizing a joint. A surgeon must always rely on his or her own professional clinical judgment when deciding whether to. These low profile plates with polyaxial bushings provide freedom to direct the locking screws within the anatomical template, based on the fracture pattern and bone quality for better fixation. This hybrid fixation concept is designed to allow the surgeon to.
Optilock upper extremity plating system proximal humeral. Patients should be seen in the fracture clinic or by an interested gp within 7 days for followup with x. Proximal humeral fracture protocol jay carson, md rehabilitation of the proximal humeral fractures is essential because adequate motion is needed for optimum function. These plates are low profile, stainless steel and available in 2hole 75mm, 4hole 99mm, 6hole 123mm and 10hole 171mm lengths. The axsos locking plate system is indicated for fixation of long bone fractures including fractures of the distal radius, the proximal humerus, the distal tibia, proximal tibia and the distal femur. Please refer to the compatibility table on page 19 showing sps and axsos 3 titanium compatibility. For complex and unstable fractures locking proximal humerus plate. Especially common in elderly individuals due to osteoporosis, proximal humerus fractures are among the most common broken bones in the shoulder.
Proximal humerus fractures make up 45% of all fractures. The most useful rehabilitation protocol is the threephase system. Axsos 3 titanium screws used with the axsos 3 titanium proximal lateral humerus plates. Current concepts in locking plate fixation of proximal.
Any surgical intervention should have clear aims and indications and the appropriate technique should be selected for each individual. Insert the stabilization pin of the aiming block into the specially provided hole on the proximal humeral locking. This site complies with the honcode standard for trustworthy health information. The system consists of a proximal humeral component, a range of shafts in 15mm increments to suit differing lengths of resections, a range of hydroxyapatite coated and uncoated collars of different diameters to match the size of the resected bone and a range of cemented stems to fit the intramedullary canal. The axsosm locking plate system is intended for use in long bone fracture fixation. There is different consensus concerning the best treatment option for each patient, either by nonoperative management, internal fixation or by prosthetic replacement. The head caput humeri, is nearly hemispherical in form. The usual treatment for this fracture is immobilisation of the shoulder in a sling, body swathe or shoulder immobiliser. The axsos periarticular locking plate system is strykers range of axially stable locking plates with locking screws designed to treat peri or intraarticular fractures. Displaced and comminuted fractures of the proximal humerus pose difficult management problems for the orthopaedic surgeon. May allow for a less rigid construct, potentially resulting in increased callus formation and secondary healing 2. The material on this website is designed to support, not replace, the relationship that exists between ourselves and our patients. A sarmiento, pb kinman, eg galvin, rh schmitt and jg phillips functional bracing of fractures of the shaft of the humerus this information is current as of january 22.
Proximal humerus plating system is designed to minimize the risk of some of the complications commonly associated with treating proximal humerus fractures by its design to. The system design is based on clinical input from an international panel of. Proximal humerus fractures account for approximately 5% of all fractures. Consult strykers entire axsos 3 titanium catalogue on medicalexpo. Axsos locking plate system five periarticular plates covering four anatomical regions. Fractures of the proximal humerus account for 45% of all fractures, making them a common upper extremity injury. Establishing the appropriate position the authors 2017 of. Periloc periarticular locked plating system for upper and. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. Insert the stabilization pin of the aiming block into the specially provided hole on the proximal humeral locking plate see two red arrows on. Distal tibial locking plate features, technique and tips gavin bowyer southampton university hospitals, uk.
Axsos prox humeral plate, stryker shoulderdoc by prof. Most proximal humerus fractures are nondisplaced not out of position, but about 1520 percent of these fractures are displaced, and these may require more invasive treatment. Proximal humerus bone fractures overview verywell health. Proximal lateral tibial plate distal lateral femoral plate proximal humeral plate theaxsos locking plate system is designed to treat periarticular or intraarticular fractures of the distal femur, proximal humerus, proximal tibia, and the distal tibia. All of the above axsos 3 titanium screws have a t15 screw head interface. Proximal lateral tibia proximal medial tibia axsos 3 titanium screws. Biomechanical analysis of plate systems for proximal humerus. Proximal humeral fractures, which typically occur in elderly persons, are among the most common fractures. Proximalfirst method this technique allows for initial fixation of the plate to the humeral head followed by its reduction to the shaft. Risk factors for proximal humerus fracture article pdf available in american journal of epidemiology 1604. Impaired bone quality and considerable comorbidities pose special challenges in the growing aging population.
Axsos proximal humerus ts operative technique stryker yumpu. The system design is based on clinical input from an international panel of experienced surgeons, data from literature, and both practicaland biomechanical testing. In the over65 patient population, this figure is reported much higher, at 10%, often related to factors such as osteoporosis. Clinical example using a, b, c, and e level screws 1 features anatomicallyshaped ten suture holes around the perimeter of the proximal end proximal locking holes accept 3. Multi component instruments must be disassembled for cleaning. Proximal lateral tibial plate distal anterolateral tibial plate distal medial tibial plate the axsos locking plate system is designed to treat periarticular or intraarticular fractures of the proximal humerus, distal femur, proximal tibia, and the distal tibia. The axsos 3 titanium locking plate system is intended for long bone fracture fixation.
The system design is based on clinical input from an international panel of experienced surgeons, data from literature, and both practical and. The upper or proximal extremity of the humerus consists of the bones large rounded head joined to the body by a constricted portion called the neck, and two eminences, the greater and lesser tubercles. Patented locking screw head design helps ease extraction 1. Plating system, optilock proximal humeral plates are intended to address complex fractures of the proximal humerus.
Complications after operative treatment are frequent, in particular loss of reduction with varus malalignment and. Nov 18, 2014 the management of proximal humerus fractures in adults is a challenging and demanding task. Eighty percent of these fractures heal with nonoperative treatment measures. Hemiarthroplastyorif proximal humerus fracture protocol. Proximal humerus fractures orthopaedicsone articles. Philos proximal humeral internal locking system quick steps for insertion in osteoporotic bone philos 9 proximal screw holes in section ae for lcp locking screws b 3. Axsos proximal tibia operative technique cambridge. Patient selection factors to be considered include. The system is indicated for fixation of long bone fractures including but not limited to fractures of the. Knifelight femur axsos locking plate system carpal tunnel.
Axsos 3 titanium proximal lateral humerus locking plate system. A myriad of nonsurgical and surgical treatment options exist for these injuries, including shortterm immobilization and early physical therapy, percutaneous fixation, plate osteosynthesis, intramedullary nailing, hemiarthroplasty, and reverse shoulder arthroplasty. Oct 01, 2010 an analysis of the literature reveals few published series on the results of surgical treatment for nonunions of the proximal humerus. Periloc periarticular locked plating system for upper and lower extremity fractures including. The development of technologies and techniques for these plates, during the recent decades, promise a bright future for their clinical use. The pdf of the article you requested follows this cover page. Optilock upper extremity plating system proximal humeral plates. Proximal and distal tibia, proximal humerus and distal femur. Indications include the proximal humerus, distal femur, and proximal and distal tibia. A proximal humerus fracture is a common injury to the shoulder. Biomechanical analysis of plate systems for proximal. Circa 85% of the cases can be treated with a nonoperative approach while the remaining complicated fractures require. Axsos 3 ti proximal lateral humerus operative technique. This publication sets forth detailed recommended procedures for using.
Healy and colleagues 1 reported on the outcome of 25 proximal. Axsostm proximal lateral humerus ts long plates indications for use. If a fracture or fracture repair is stable, then therapy should be started early. Functional bracing of fractures of the shaft of the humerus. Each of these plates is anatomically sidespecific, e. The axsos locking plate system is intended for use in long bone fracture fixation. You can use it in conjunction with proximal medial tibia plate. However, the incidence is increasing with aging of the population.
The present study aimed to determine anatomic references for the placement of five proximal humerus locking plates. Open reduction and internal fixation with plates is one of the leading modes of operative treatment for these fractures. Shaftfirst method this technique allows for up to 5mm of proximal. Proximal humeral plating system is indicated for fixation of fractures and fracture dislocations, fusions, osteotomies and nonunions of the humerus, particularly in osteopenic bone. In fact, in patients older than 65, proximal humerus fractures are the third most common broken bone after hip fractures and wrist fractures. The system design is based on clinical input from an international panel of experienced.
Despite numerous available treatment strategies, the management of complex proximal humeral fractures remains demanding. Proximal humerus plating system is designed to provide intraoperative flexibility and efficiency to the surgical team. The periloc proximal humerus locking plate may be implanted using either a proximalfirst or shaftfirst screw insertion method. There is currently insufficient evidence to suggest superiority of one treatment option over the others. Appendix e1 indication for use statement indications for use 5slok number if known. The anterolateral approach to the proximal humerus for.
Proximal humerus fractures are the third most common in the human body but their management remains controversial. May allow for a less rigid construct, potentially resulting in increased callus formation and secondary healing 1. Rehabilitation guidelines for proximal humerus fracture non operative 2 p a g e phase ii continued precautions dc sling x 3 weeks if cleared by md aarom to 90 degrees forward flexion and 40 degrees er suggested therapeutic exercises arom cervical, elbow, wrist and hand pendelums gripping exercises scapular pnf. The axsos 3 titanium design concept draws upon the broad clinical expertise of an international panel of surgeons who developed, tested and validated the axsos system. Most proximal humeral fractures do not require reduction as remodelling is extremely effective in the proximal humerus. Good outcomes depend on detailed fracture evaluation, careful patient selection with thorough consideration of individual patient characteristics, comorbidities and functional expectations and advanced surgical expertise across a wide range of. Its upper surface is rounded and marked by three flat impressions. Nonoperative management is associated with good outcomes in the majority of proximal humerus fractures in adults. Axsos 3 titanium proximal lateral humerus locking plate. Axsos proximal humerus operative technique stryker yumpu. The fracture is actually at the top of the arm bone the humerus. The most comprehensive stainless steel proximal humerus locked. Proximal lateral humerus ts plates of the axsosm locking plate system cleared under k0610l2 in regards to intended use, design, materials, and operational principles as a bone fixation device.
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