Abstract
We describe a novel internal fixation device, and report on 61 patients (mean age:
76.8 years) whose proximal humeral fractures were managed with this technique. The
two-part titanium implant consists of a circular staple impacted into the cancellous
bone of the humeral head, and a spigotted diaphyseal stem that inserts into the staple
“cup”. Of the 61 cases reviewed, ten had two-part fractures, 27 had three-part, and
24 had four-part fractures. In the ten two-part fracture patients, mean active forward
elevation was 120°. The results were: six excellent, two good, and two fair. In the
27 three-part fracture patients, mean active forward elevation was 120°. The results
were: 13 excellent, nine good, and five fair. In the 24 four-part fracture patients,
mean active forward elevation was 94°; there were three excellent, eight good, eight
fair, and five poor results. There were 13 cases of avascular necrosis, and two cases
of tuberosity non-union. Only three cases needed conversion to hemiarthroplasty. This
technique should simplify the surgery of these fractures in the elderly, and reduce
the need for arthroplasty.
Key words
proximal humerus - fractures - elderly - internal fixation - Bilboquet
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Prof. L. Doursounian
Service de Chirurgie Orthopédique · Hôpital Saint Antoine
184 rue du Faubourg Saint Antoine
75012 Paris
France
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Email: levon.doursounian@wanadoo.fr