Skip to main content

Advertisement

SpringerLink
Log in

A prospective study for the treatment of proximal humeral fractures with the Galaxy Fixation System

  • Original Article
  • Published:
MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

Background

Fractures of the proximal humerus represent a common problem in clinical practice; in particular for three- or four-part fractures, there is no consensus regarding which is the best treatment. The aim of our study was to report clinical and radiological outcomes in patients treated with the Galaxy Fixation System™ for a proximal humerus fracture.

Materials and methods

Thirty-two patients of which 18 (56.25%) women, and 14 (43.75%) men suffering from proximal humerus fractures were treated using the Galaxy Fixation System™. Fractures were classified according to Neer and only patients with a three- or four-part fracture with two-thirds of the methaphysis intact were included. Clinical examination included the Constant-Murley score, UCLA score and Quick DASH evaluated at 6, 12 and 24 months after surgery. In addition, at the final follow-up, patients were asked to complete the SF-12 questionnaire. The humeral head-shaft angle was evaluated by radiographs the day after surgery, as well as after 12 and 24 months.

Results

All 32 patients were available for the 6th, 12th and 24th month follow-up examination. The mean interval between trauma and surgery was 2.7 days (range 0–6 days). The period of hospital stay ranged from 2 to 8 days with an average of three days. The time of healing ranged from 4 to 10 weeks with an average of 7 weeks. The mean Constant score increased from 72.9 after 6 months to a mean of 82.8 at 12 months (p < 0.05) to 88.9 at 24 months (p < 0.05). UCLA score ranged from 27.5 at 6 months to 29.5 at 12 months (p < 0.05) and finally improved to 32.3 at final follow-up (p < 0.05). Quick DASH varied from 7.2 at 6 months after surgery to 5.2 at 12 months after surgery (p > 0.05) and reached the value of 3.1 after 24 months (p > 0.05). Mean Mental Component (MCS) resulted in a value of 48.1, while the Physical Component (PCS) was 52.7. The mean head-shaft angulation was 137.6° the day after surgery compared with 137.5° (p > 0.05) measured 12 months later, and 137.2° measured 24 months later (p > 0.05).

Conclusions

Galaxy Fixation System™ is a safe and efficient procedure for the treatment of three- or four-part proximal humerus fractures, providing an excellent outcome.

Level of evidence

Prospective case series, Level IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Baron JA, Barrett JA, Karagas MR (1996) The epidemiology of peripheral fractures. Bone 18:209S–213S

    Article  CAS  PubMed  Google Scholar 

  2. Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37:691–697

    Article  PubMed  Google Scholar 

  3. Lind T, Krøner K, Jensen J (1989) The epidemiology of fractures of the proximal humerus. Arch Orthop Trauma Surg 108:285–287

    Article  CAS  PubMed  Google Scholar 

  4. Roux A, Decroocq L, El Batti S, Bonnevialle N, Moineau G, Trojani C, Boileau P, de Peretti F (2012) Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol Surg Res 98:715–719

    Article  CAS  PubMed  Google Scholar 

  5. Anchuela-Ocaña M, Gómez-García M, Medina-Herráez E, Riquelme-Arias G, Pérez Martín A (1997) Fracturas proximales del húmero. Revisión de las alternativas terapéuticas. Rev Ortop Traumatol 41:205–212

    Google Scholar 

  6. Neer CS 2nd (1970) Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am 52:1077–1089

    Article  PubMed  Google Scholar 

  7. Kralinger F, Schwaiger R, Wambacher M, Farrell E, Menth-Chiari W, Lajtai G, Hubner C, Resch H (2004) Outcome after primary hemiarthroplasty for fracture of the head of the humerus. A retrospective multicentre study of 167 patients. J Bone Joint Surg (Br) 86:217–219

    Article  CAS  Google Scholar 

  8. Herscovici D, Saunders DT, Johnson MP, Sanders R, DiPasquale T (2000) Percutaneous fixation of proximal humeral fractures. Clin Orthop 375:97–104

    Article  Google Scholar 

  9. Cornell CN, Levine D, Pagnani MJ (1994) Internal fixation of proximal humerus fractures using the screw-tension band technique. J Orthop Trauma 8:23–27

    Article  CAS  PubMed  Google Scholar 

  10. Broder K, Christiano A, Zuckerman JD, Egol K (2013) Management of proximal humerus fractures with the Equinoxe locking plate system. Bull Hosp Joint Dis 73:107–110

    Google Scholar 

  11. Vachtsevanos L, Hayden L, Desai AS, Dramis A (2014) Management of proximal humerus fractures in adults. World J Orthop 5:685–693

    Article  PubMed  PubMed Central  Google Scholar 

  12. Sanz Reig J, Bendala Tufanisco C, Lizaur Utrilla A, Cebrián Gómez R (2003) El enclavado percutáneo en el tratamiento de las fracturas desplazadas en dos y tres fragmentos de la extremidad proximal del húmero. Rev Ortop Traumatol 47:26–30

    Google Scholar 

  13. Martin C, Guillen M, Lopez G (2006) Treatment of 2- and 3-part fractures of the proximal humerus using external fixation: a retrospective evaluation of 62 patients. Acta Orthop 77:275–278

    Article  PubMed  Google Scholar 

  14. Monga P, Verma R, Sharma VK (2009) Closed reduction and external fixation for displaced proximal humeral fractures. J Orthop Surg 17:142–145

    Article  Google Scholar 

  15. Schliemann B, Hartensuer R, Koch T, Theisen C, Raschke MJ, Kösters C, Weimann A (2015) Treatment of proximal humerus fractures with a CFR-PEEK plate: 2-year results of a prospective study and comparison to fixation with a conventional locking plate. J Shoulder Elbow Surg 24:1282–1288

    Article  PubMed  Google Scholar 

  16. Young AA, Hughes JS (2008) Locked intramedullary nailing for treatment of displaced proximal humerus fractures. Orthop Clin North Am 39:417–428

    Article  PubMed  Google Scholar 

  17. Lopiz Y, Garcia-Coiradas J, Garcia-Fernandez C, Marco F (2014) Proximal humerus nailing: a randomized clinical trial between curvilinear and straight nails. J Shoulder Elbow Surg 23:369–376

    Article  PubMed  Google Scholar 

  18. Kristiansen B (1987) External fixation of proximal humerus fracture. Clinical and cadaver study of pinning technique. Acta Orthop Scand 58:645–648

    Article  CAS  PubMed  Google Scholar 

  19. Kristiansen B, Kofoed H (1988) Transcutaneous reduction and external fixation of displaced fractures of the proximal humerus. A controlled clinical trial. J Bone Joint Surg Br 70:821–824

    Article  CAS  PubMed  Google Scholar 

  20. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    Google Scholar 

  21. Amstutz HC, Sew Hoy AL, Clarke IC (1981) UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res 155:7–20

    Google Scholar 

  22. Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 29:602–608

    Article  CAS  PubMed  Google Scholar 

  23. Ware JE, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233

    Article  PubMed  Google Scholar 

  24. Solberg BD, Moon CN, Franco DP, Paiement GD (2009) Surgical treatment of three and four-part proximal humeral fractures. J Bone Joint Surg Am 91:1689–1697

    Article  PubMed  Google Scholar 

  25. El-Alfy BS (2011) Results of the percutaneous pinning of proximal humerus fractures with a modified palm tree technique. Int Orthop 35:1343–1347

    Article  PubMed  PubMed Central  Google Scholar 

  26. Plecko M, Kraus A (2005) Internal fixation of proximal humerus fractures using the locking proximal humerus plate. Oper Orthop Traumatol 17:25–50

    Article  PubMed  Google Scholar 

  27. Gerber C, Werner CM, Vienne P (2004) Internal fixation of complex fractures of the proximal humerus. J Bone Joint Surg Br 86:848–855

    Article  CAS  PubMed  Google Scholar 

  28. Moonot P, Ashwood N, Hamlet M (2007) Early results for treatment of three- and four-part fractures of the proximal humerus using the PHILOS plate system. J Bone Joint Surg Br 89:1206–1209

    Article  CAS  PubMed  Google Scholar 

  29. Konrad G, Bayer J, Hepp P, Voigt C, Oestern H, Kääb M, Luo C, Plecko M, Wendt K, Köstler W, Südkamp N (2010) Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate Surgical technique. J Bone Joint Surg Am 92(Suppl 1 Pt 1):85–95

    Article  PubMed  Google Scholar 

  30. Ruchholtz S, Hauk C, Lewan U, Franz D, Kühne C, Zettl R (2011) Minimally invasive polyaxial locking plate fixation of proximal humeral fractures: a prospective study. J Trauma 71:1737–1744

    PubMed  Google Scholar 

  31. Giannoudis PV, Xypnitos FN, Dimitriou R, Manidakis N, Hackney R (2012) Internal fixation of proximal humeral fractures using the Polarus intramedullary nail: our institutional experience and review of the literature. J Orthop Surg Res 7:39

    Article  PubMed  PubMed Central  Google Scholar 

  32. Rajasekhar C, Ray PS, Bhamra MS (2001) Fixation of proximal humeral fractures with the Polarus nail. J Shoulder Elbow Surg 10:7–10

    Article  CAS  PubMed  Google Scholar 

  33. Sforzo CR, Wright TW (2009) Treatment of acute proximal humerus fractures with a polarus nail. J Surg Orthop Adv 18:28–34

    PubMed  Google Scholar 

  34. Popescu D, Fernandez-Valencia JA, Rios M, Cuñé J, Domingo A, Prat S (2009) Internal fixation of proximal humerus fractures using the T2-proximal humeral nail. Arch Orthop Trauma Surg 129:1239–1244

    Article  PubMed  Google Scholar 

  35. Adedapo AO, Ikpeme JO (2001) The results of internal fixation of three and four-part proximal humeral fractures with the Polarus nail. Injury 32:115–121

    Article  CAS  PubMed  Google Scholar 

  36. Owsley KC, Gorczyca JT (2008) Fracture displacement and screw cut out after open reduction and locked plate fixation of proximal humeral fractures [corrected]. J Bone Joint Surg Am 90:233–240

    Article  PubMed  Google Scholar 

  37. Krappinger D, Bizzotto N, Riedmann S, Kammerlander C, Hengg C, Kralinger FS (2011) Predicting failure after surgical fixation of proximal humerus fractures. Injury 42:1283–1288

    Article  PubMed  Google Scholar 

  38. Bogner R, Hübner C, Matis N, Auffarth A, Lederer S, Resch H (2008) Minimally-invasive treatment of three and four-part fractures of the proximal humerus in elderly patients. J Bone Joint Surg Br 90:1602–1607

    Article  CAS  PubMed  Google Scholar 

  39. Bonnevialle N, Ibnoulkatib A, Mansat P, Bonnevialle P (2013) Kapandji pinning and tuberosities fixation of three and four-part fractures of the proximal humerus. Int Orthop 37:1965–1971

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kodraliu G, Mosconi P, Groth N, Carmosino G, Perilli A, Gianicolo EA, Rossi C, Apolone G (2001) Subjective health status assessment: evaluation of the Italian version of the SF-12 Health Survey. Results from the MiOS Project. J Epidemiol Biostat 6:305–316

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy

    R. D’Ambrosi

  2. Centro Traumatologico Ortopedico, U.O. Clinica Ortopedica e Traumatologica, Milan, Italy

    R. D’Ambrosi, F. Palumbo, A. Barbato & R. M. Facchini

Authors
  1. R. D’Ambrosi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Palumbo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Barbato
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. M. Facchini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. D’Ambrosi.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.

Ethical standard

The study was approved by the research ethics committee (or institutional review board).

Human and animal rights

All procedures involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments.

Informed concent

All patients gave their informed consent prior to being included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

D’Ambrosi, R., Palumbo, F., Barbato, A. et al. A prospective study for the treatment of proximal humeral fractures with the Galaxy Fixation System. Musculoskelet Surg 101, 11–17 (2017). https://doi.org/10.1007/s12306-016-0434-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-016-0434-z

Keywords

Search

Navigation