Impaired bone quality and considerable comorbidities pose special challenges in the growing aging population. Axsos 3 ti proximal lateral humerus operative technique. Each of these plates is anatomically sidespecific, e. Displaced and comminuted fractures of the proximal humerus pose difficult management problems for the orthopaedic surgeon. The present study aimed to determine anatomic references for the placement of five proximal humerus locking plates. The system design is based on clinical input from an international panel of. Axsos 3 titanium proximal lateral humerus locking plate. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. The usual treatment for this fracture is immobilisation of the shoulder in a sling, body swathe or shoulder immobiliser. Axsos locking plate system five periarticular plates covering four anatomical regions. Patient selection factors to be considered include. Proximal humerus bone fractures overview verywell health. The axsos 3 titanium locking plate system is intended for long bone fracture fixation.
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. This site complies with the honcode standard for trustworthy health information. The aiming block for proximal humeral plate provides for mounting of the lcp drill sleeve 3. Any surgical intervention should have clear aims and indications and the appropriate technique should be selected for each individual. 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.
Distal tibial locking plate features, technique and tips gavin bowyer southampton university hospitals, uk. Proximal humeral fracture protocol jay carson, md rehabilitation of the proximal humeral fractures is essential because adequate motion is needed for optimum function. Nov 17, 2019 a proximal humerus fracture occurs when the ball, of the ballandsocket shoulder joint, is broken. The material on this website is designed to support, not replace, the relationship that exists between ourselves and our patients. Despite numerous available treatment strategies, the management of complex proximal humeral fractures remains demanding. 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. This publication sets forth detailed recommended procedures for using. In fact, in patients older than 65, proximal humerus fractures are the third most common broken bone after hip fractures and wrist fractures. The anterolateral approach to the proximal humerus for.
Axsos proximal humerus operative technique stryker yumpu. 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. For complex and unstable fractures locking proximal humerus plate. 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. These plates are low profile, stainless steel and available in 2hole 75mm, 4hole 99mm, 6hole 123mm and 10hole 171mm lengths. The system design is based on clinical input from an international panel of experienced surgeons, data from literature, and both practicaland biomechanical testing. Establishing the appropriate position the authors 2017. Proximalfirst method this technique allows for initial fixation of the plate to the humeral head followed by its reduction to the shaft. The system design is based on clinical input from an international panel of experienced.
Biomechanical analysis of plate systems for proximal. The conventional sps small and basic fragment sets are standard plating. The head caput humeri, is nearly hemispherical in form. For complex and unstable fractures locking proximal. This hybrid fixation concept is designed to allow the surgeon to.
The fracture is actually at the top of the arm bone the humerus. Periloc periarticular locked plating system for upper and. Insert the stabilization pin of the aiming block into the specially provided hole on the proximal humeral locking plate see two red arrows on. Optilock upper extremity plating system proximal humeral. 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. Nov 18, 2014 the management of proximal humerus fractures in adults is a challenging and demanding task. 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. Appendix e1 indication for use statement indications for use 5slok number if known.
There is currently insufficient evidence to suggest superiority of one treatment option over the others. 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. May allow for a less rigid construct, potentially resulting in increased callus formation and secondary healing 2. Axsos proximal tibia operative technique cambridge. Current concepts in locking plate fixation of proximal. 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. The periloc proximal humerus locking plate may be implanted using either a proximalfirst or shaftfirst screw insertion method.
Proximal humerus fractures make up 45% of all fractures. Multi component instruments must be disassembled for cleaning. Open reduction and internal fixation with plates is one of the leading modes of operative treatment for these fractures. Healy and colleagues 1 reported on the outcome of 25 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. 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.
Optilock upper extremity plating system proximal humeral plates. The axsos periarticular locking plate system is strykers range of axially stable locking plates with locking screws designed to treat peri or intraarticular fractures. Proximal humerus plating system is designed to provide intraoperative flexibility and efficiency to the surgical team. Axsos 3 titanium proximal lateral humerus locking plate system. Need for alignment and stabilization of bone fractures 2. Proximal lateral tibia proximal medial tibia axsos 3 titanium screws. 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. You can use it in conjunction with proximal medial tibia plate. Axsostm proximal lateral humerus ts long plates indications for use. Proximal humerus fractures account for approximately 5% of all fractures. The most comprehensive stainless steel proximal humerus locked. 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. 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. Knifelight femur axsos locking plate system carpal tunnel. 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. The axsosm locking plate system is intended for use in long bone fracture fixation. The axsos locking plate system is intended for use in long bone fracture fixation. The system is indicated for fixation of long bone fractures including but not limited to fractures of the.
Proximal humerus fractures orthopaedicsone articles. Risk factors for proximal humerus fracture article pdf available in american journal of epidemiology 1604. May allow for a less rigid construct, potentially resulting in increased callus formation and secondary healing 1. Complications after operative treatment are frequent, in particular loss of reduction with varus malalignment and. If a fracture or fracture repair is stable, then therapy should be started early.
Biomechanical analysis of plate systems for proximal humerus. Consult strykers entire axsos 3 titanium catalogue on medicalexpo. There is different consensus concerning the best treatment option for each patient, either by nonoperative management, internal fixation or by prosthetic replacement. The system design is based on clinical input from an international panel of experienced surgeons, data from literature, and both practical and. Circa 85% of the cases can be treated with a nonoperative approach while the remaining complicated fractures require. Please refer to the compatibility table on page 19 showing sps and axsos 3 titanium compatibility. Periloc periarticular locked plating system for upper and lower extremity fractures including. Hemiarthroplastyorif proximal humerus fracture protocol.
Establishing the appropriate position the authors 2017 of. Indications include the proximal humerus, distal femur, and proximal and distal tibia. 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 humerus ts operative technique stryker yumpu. Eighty percent of these fractures heal with nonoperative treatment measures. The pdf of the article you requested follows this cover page. Its upper surface is rounded and marked by three flat impressions.
The development of technologies and techniques for these plates, during the recent decades, promise a bright future for their clinical use. 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. In the over65 patient population, this figure is reported much higher, at 10%, often related to factors such as osteoporosis. Patented locking screw head design helps ease extraction 1. Axsos 3 titanium screws used with the axsos 3 titanium proximal lateral humerus plates. The anatomic fixation system for the proximal humerus. Most proximal humeral fractures do not require reduction as remodelling is extremely effective in the proximal humerus. Proximal and distal tibia, proximal humerus and distal femur. Functional bracing of fractures of the shaft of the humerus.
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. Plating system, optilock proximal humeral plates are intended to address complex fractures of the proximal humerus. Fractures of the proximal humerus account for 45% of all fractures, making them a common upper extremity injury. Axsos prox humeral plate, stryker shoulderdoc by prof. Patients should be seen in the fracture clinic or by an interested gp within 7 days for followup with x. Especially common in elderly individuals due to osteoporosis, proximal humerus fractures are among the most common broken bones in the shoulder. Oct 01, 2010 an analysis of the literature reveals few published series on the results of surgical treatment for nonunions of the proximal humerus. Shaftfirst method this technique allows for up to 5mm of proximal.
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. A proximal humerus fracture is a common injury to the shoulder. Proximal humeral fractures, which typically occur in elderly persons, are among the most common fractures. 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. Proximal humerus fractures are the third most common in the human body but their management remains controversial. However, the incidence is increasing with aging of the population. The most useful rehabilitation protocol is the threephase system. Insert the stabilization pin of the aiming block into the specially provided hole on the proximal humeral locking. Nonoperative management is associated with good outcomes in the majority of proximal humerus fractures in adults.
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