$comminuted fracture greater tuberosity humerus$

$comminuted fracture greater tuberosity humerus$

#Comminuted fracture greater tuberosity humerus software

Once reduction was confirmed with a C-arm X-ray machine after temporary fixation, the plate (Philos plate DePuy Synthes, Oberdorf, Switzerland 3.5 mm LCP proximal humerus plate, IRENE, Tianjin, China) was fixed with screws. Subsequently, the humeral head and shaft were reduced. An adequate fibular strut was inserted into the intramedullary canal through the fracture site and medialized toward the calcar to reduce the column in patients with a comminuted medial hinge or severe osteoporosis. Nonabsorbable sutures were passed through the junction of the tuberosities and rotator cuff to promote mobilization and reduce tuberosities. The fracture site was exposed using the deltopectoral approach. We placed patients in a “beach chair” position on an operating table under general anesthesia. Sixteen well-trained orthopedic surgeons performed all the operations. Horizontal and vertical displacements of the main fragment relative to the humeral head were measured on coronal and axial CT, respectively, and the final displacement of the main fragment was the sum of the horizontal and vertical displacements.

#Comminuted fracture greater tuberosity humerus software

Raw preoperative CT data in the axial plane were imported into Mimics software to reconstruct and isolate 3-D models of the main fragment, and then the volume and surface area were measured. The volume and surface area of the main GT fragment were measured using Mimics software (Materialise NV, Leuven, Belgium), which is a three-dimensional modeling software widely used in medical research. The GT was defined as comminuted if there were more than two GT fracture fragments, which were estimated based on X-ray and CT (only fragments with a volume larger than 1/4 of the GT).

$comminuted fracture greater tuberosity humerus$

The condition of the medial hinge was divided into comminuted or non-comminuted. According to Hertel’s report, we defined humeral head extension as part of the metaphysis that remains attached to the head and the longer the extension, the more likely the head is perfused. We measured proximal humeral BMD using the proximal humeral average cortical bone thickness, and an average cortical bone thickness of less than 6 mm indicated low BMD of the proximal humerus. Three orthopedic surgeons with more than 10 years of experience in the Department of Orthopedics classified fractures according to the Neer classification system. Preoperative factors included sex, age, body mass index, fracture type, fracture-dislocation, proximal humeral bone mineral density (BMD), humeral head extension, hinge integrity, comminuted GT, volume and surface area of the main GT fragment, and displacement of the main GT fragment. Potential risk factors for nonanatomic GT healing included preoperative and intraoperative factors. Anatomic GT healing was defined as the absence of the three complications mentioned above and correct positioning of the GT. Nonunion and osteolysis of the GT were identified by comparing preoperative, immediate postoperative, and outpatient follow-up radiographs (Figs. It was defined as high when the summit of the GT was less than 5 mm below the summit of the head and as low when the summit of the GT was more than 10 mm below the summit of the head. Malposition of the GT was defined as the summit of the GT being less than 5 mm or more than 10 mm below the summit of the humeral head on the anteroposterior radiograph in neutral rotation. According to previous studies, the GT was considered correctly positioned when it was visible in the anteroposterior view in neutral rotation, and its summit was between 5 and 10 mm below the summit of the head (Fig. Nonanatomic GT healing included malposition, nonunion, and osteolysis of the GT. We divided all patients into two groups, the anatomic GT healing group (AH) and the nonanatomic GT healing group (NH), depending on the radiographic outcomes of the GT.

$comminuted fracture greater tuberosity humerus$