THIS INFORMATION IS FOR HEALTHCARE PROFESSIONALS ONLY

Proximal humeral fractures account
for 10% of all bone fractures

They are the third most frequent fracture in elderly people after hip fracture
and distal forearm fracture.

  • More than 70% of patients with a proximal humeral fracture are older than 60 years
  • About 75% are women
  • From 40 years of age the risk of fracture begins to increase exponentially

The evaluation and management of these injuries is often controversial
and there is neither a general consensus nor a fully satisfying treatment. *

The use of a dedicated external fixator is a valuable option for the treatment of proximal humeral fractures

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Similar benefits
to those of traditional pinning technique *

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Better biomechanical characteristics *

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Good clinical outcomes and a 3% revision rate *

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Varus displaced proximal humeral fracture treated with Galaxy Fixation Shoulder

80 year-old male patient Cause of injury: fall on the left shoulder

At presentation he had pain and complete functional impairment. He was neurovascularly intact.

The CT scan showed a significant impaction of the humeral head, a medialization of the shaft with internal rotation of the humeral head.

The patient was generally fit and active and a surgical intervention with closed reduction and fixation with Galaxy Shoulder was suggested in order to reduce the fracture, increase the chance of anatomical healing, and provide a faster return to the activity of daily living.

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Displaced humeral head and greater tuberosity treated with
Galaxy Fixation Shoulder

70 year-old female patient
Cause of injury: fall on the right shoulder

At presentation she had pain and complete functional impairment. She was neurovascularly intact.

The X-ray showed a displaced humeral head and greater tuberosity. The CT scan showed a valgus-displaced proximal humeral fracture.

The patient was affected by rheumatoid arthritis. Surgical intervention was proposed and scheduled 4 days after the trauma. An open reduction using a deltopectoral approach was performed to reduce the fracture.

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Question Answer
In young patients, do you prefer plating or nailing for better reduction? Galaxy Shoulder Fixation System is a tool for fixation not for reduction. Being a tool for fixation, we cannot blame it for a bad reduction. Similarly, when we face bad reductions after fracture fixation with a plate or a nail, we blame the surgeon and not the tool. For the same reason, our KOLs suggest an open reduction and a percutaneous fixation if the reduction is not satisfactory after closed manoeuvres
In which type of fractures do you find most difficult to decide between intramedullary nailing and external fixation osteosynthesis? KOLs have abandoned other fixation devices, confident by their results using the external fixator. Having said that, in case of fracture of 1 cm distal to the surgical neck, they would consider a plate or a nail because it is difficult to insert the 2 oblique pins when the fracture is too distal.
The plate is more investigated with greater blood loss compared to a minimally invasive approach, but rapid mobilisation is provided anyway. What do you think about it? In our KOLs experience, the average old patient affected by 3 to 4 part PHF, treated with a plate or a nail, does not resume the activity of daily life very soon, despite surgeon post-op suggestions. In young patients, it is easier regardless of the tool you might use. The limiting factor is usually the pain. Our KOLs belief, supported by some experience coming from hospitals that are still using plate along with the external fixator, is that the treatment with the external fixator could provide a faster return to activity of daily life due to less pain and stiffness.
Are there review articles about this approach? If so, what are their conclusions vs plating, nailing, pinning? There are no studies available yet comparing all different techniques

About Orthofix

Orthofix Medical Inc. is a diversified, global medical device company focused on improving patients’ lives by providing superior reconstructive and regenerative musculoskeletal solutions to physicians worldwide. The company has four strategic business units under two pillars: Orthofix Spine includes BioStim, Biologics, and Spine Fixation, and Orthofix Extremities