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Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures: A Systematic Review and the Authors’ Preferred Surgical Technique

BACKGROUND: Proximal humerus fractures are common problems plaguing the elderly population. PURPOSE: The purposes of this study were to determine the outcomes of fibular strut allografts in treatment of proximal humerus fractures with open reduction internal fixation (ORIF) and to present the author...

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Autores principales: Saltzman, Bryan M., Erickson, Brandon J., Harris, Joshua D., Gupta, Anil K., Mighell, Mark, Romeo, Anthony A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2016
Materias:
8
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962341/
https://www.ncbi.nlm.nih.gov/pubmed/27504463
http://dx.doi.org/10.1177/2325967116656829
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author Saltzman, Bryan M.
Erickson, Brandon J.
Harris, Joshua D.
Gupta, Anil K.
Mighell, Mark
Romeo, Anthony A.
author_facet Saltzman, Bryan M.
Erickson, Brandon J.
Harris, Joshua D.
Gupta, Anil K.
Mighell, Mark
Romeo, Anthony A.
author_sort Saltzman, Bryan M.
collection PubMed
description BACKGROUND: Proximal humerus fractures are common problems plaguing the elderly population. PURPOSE: The purposes of this study were to determine the outcomes of fibular strut allografts in treatment of proximal humerus fractures with open reduction internal fixation (ORIF) and to present the authors’ preferred surgical technique. The hypothesis was that the use of fibular strut allografts in treating proximal humerus fractures with ORIF will provide low reoperation rates with acceptable outcomes. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic review was registered with PROSPERO and performed with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines using 3 publicly available free databases. Therapeutic clinical outcome investigations reporting arthroscopic elbow outcomes with levels of evidence 1 through 4 were eligible for inclusion. All study, subject, and surgical technique demographics were analyzed and compared between continents and countries. Statistics were calculated using Student t tests, 1-way analysis of variance, chi-square tests, and 2-proportion Z tests. RESULTS: Four studies met the inclusion criteria. While there is great heterogeneity existing in the literature surrounding use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures, current evidence shows a humeral head screw penetration rate of 3.7% with acceptable functional outcome scores, with a reoperation rate of 4.4% at a weighted mean 80.78 weeks (1.55 years) of postoperative follow-up. CONCLUSION: There is great heterogeneity that exists in the literature surrounding the use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures. Current evidence shows a screw penetration rate of 3.7% with acceptable functional outcome scores, demonstrating fibular strut allograft is a viable option for treating proximal humerus fractures.
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spelling pubmed-49623412016-08-08 Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures: A Systematic Review and the Authors’ Preferred Surgical Technique Saltzman, Bryan M. Erickson, Brandon J. Harris, Joshua D. Gupta, Anil K. Mighell, Mark Romeo, Anthony A. Orthop J Sports Med 8 BACKGROUND: Proximal humerus fractures are common problems plaguing the elderly population. PURPOSE: The purposes of this study were to determine the outcomes of fibular strut allografts in treatment of proximal humerus fractures with open reduction internal fixation (ORIF) and to present the authors’ preferred surgical technique. The hypothesis was that the use of fibular strut allografts in treating proximal humerus fractures with ORIF will provide low reoperation rates with acceptable outcomes. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic review was registered with PROSPERO and performed with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines using 3 publicly available free databases. Therapeutic clinical outcome investigations reporting arthroscopic elbow outcomes with levels of evidence 1 through 4 were eligible for inclusion. All study, subject, and surgical technique demographics were analyzed and compared between continents and countries. Statistics were calculated using Student t tests, 1-way analysis of variance, chi-square tests, and 2-proportion Z tests. RESULTS: Four studies met the inclusion criteria. While there is great heterogeneity existing in the literature surrounding use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures, current evidence shows a humeral head screw penetration rate of 3.7% with acceptable functional outcome scores, with a reoperation rate of 4.4% at a weighted mean 80.78 weeks (1.55 years) of postoperative follow-up. CONCLUSION: There is great heterogeneity that exists in the literature surrounding the use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures. Current evidence shows a screw penetration rate of 3.7% with acceptable functional outcome scores, demonstrating fibular strut allograft is a viable option for treating proximal humerus fractures. SAGE Publications 2016-07-21 /pmc/articles/PMC4962341/ /pubmed/27504463 http://dx.doi.org/10.1177/2325967116656829 Text en © The Author(s) 2016 http://creativecommons.org/licenses/by-nc-nd/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License (http://www.creativecommons.org/licenses/by-nc-nd/3.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle 8
Saltzman, Bryan M.
Erickson, Brandon J.
Harris, Joshua D.
Gupta, Anil K.
Mighell, Mark
Romeo, Anthony A.
Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures: A Systematic Review and the Authors’ Preferred Surgical Technique
title Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures: A Systematic Review and the Authors’ Preferred Surgical Technique
title_full Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures: A Systematic Review and the Authors’ Preferred Surgical Technique
title_fullStr Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures: A Systematic Review and the Authors’ Preferred Surgical Technique
title_full_unstemmed Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures: A Systematic Review and the Authors’ Preferred Surgical Technique
title_short Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures: A Systematic Review and the Authors’ Preferred Surgical Technique
title_sort fibular strut graft augmentation for open reduction and internal fixation of proximal humerus fractures: a systematic review and the authors’ preferred surgical technique
topic 8
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962341/
https://www.ncbi.nlm.nih.gov/pubmed/27504463
http://dx.doi.org/10.1177/2325967116656829
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