The Bilboquet Device for Fractures of the Proximal Humerus in the Elderly

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

References

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