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Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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Purpose
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To compare the two main surgical approaches to address proximal humerus fractures (PHFs) stratified for Neer fracture types, to demonstrate which approach gives the best result for each fracture type.
Methods
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A literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in PubMed, Web of Science, and Cochrane databases up to 4 January 2022. Inclusion criteria were studies comparing open reduction and internal fixation (ORIF) with deltopectoral (DP) approach and minimally invasive plate osteosynthesis (MIPO) with deltosplit (DS) approach of PHFs. Patient’s demographic data, fracture type, Constant–Murley Score (CMS), operation time, blood loss, length of hospital stay, complications, fluoroscopy time, and radiological outcomes were extracted. Results were stratified for each type of Neer fracture.
Results
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Eleven studies (798 patients) were included in the meta-analysis. No functional difference was found in the CMS between the two groups for each type of Neer (P = n.s.): for PHFs Neer II, the mean CMS was 72.5 (s.e. 5.9) points in the ORIF group and 79.6 (s.e. 2.5) points in the MIPO group; for Neer III, 77.8 (s.e. 2.0) in the ORIF and 76.4 (se 3.0) in the MIPO; and for Neer IV, 70.6 (s.e. 2.7) in the ORIF and 60.9 (s.e. 6.3) in the MIPO. The operation time in the MIPO group was significantly lower than in the ORIF group for both Neer II (P = 0.0461) and Neer III (P = 0.0037) fractures.
Conclusion
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The MIPO with DS approach demonstrated no significant differences in the results to the ORIF with DP approach for the different Neer fractures in terms of functional results, with a similar outcome, especially for the Neer II and III fracture types. The MIPO technique proved to be as safe and effective as the ORIF approach.
School of Medicine, Universidad de La Laguna, Tenerife, Spain
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School of Medicine, Universidad de La Laguna, Tenerife, Spain
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University of Basel, Basel, Switzerland
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School of Medicine, Universidad de Sevilla, Sevilla, Spain
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-making process when dealing with osteoporotic ankle fractures in frail patients. Narrative review results Lemon et al. ( 7 ) published the first article using TTC nailing for osteoporotic ankle fractures in 2005 reporting good functional results and
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5 - 19 available for data extraction. The first outcomes of interest were radiographic results, functional results and mortality. The secondary outcomes of interest were the rate of conversion surgery from ORIF to THA and complication rate in
School of Medicine, University of Belgrade, Serbia
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School of Medicine, University of Belgrade, Serbia
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. Fig. 6 Radial nerve injury flowchart. The functional results after microsurgical reconstruction are mostly satisfactory with low levels of disability. When there is nerve discontinuity, an end-to-end repair is the method of choice. In
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Department of Orthopaedic Surgery, International Knee and Joint Centre, Abu Dhabi, UAE
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age of 80.5 years. Functional results were satisfactory with good recovery of range of motion; however, Parker scores dropped by a mean of 1.7 points. In one patient a skin complication was observed, one patient had cardiac complications and three
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offers better results and a lower rate of re-operations. It has even been shown that Lisfranc lesions of purely ligamentous low energy have better functional results with a primary arthrodesis. 1 – 4 In a meta-analysis, Smith et al found no
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necessary in rare cases. However, an internal fixation using a direct dorsal approach is favoured once conditions allow. Regarding the functional results of surgical approach of isolated, displaced olecranon fractures, no difference was found between tension
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complications in 12% and deep infection only in 5% of cases. In total, 73.7% of patients had good functional results four years after the injury. Up to now, this report has been a standard by which all other techniques are compared. However, it must be mentioned
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-term functional results and complications in patients with knee dislocations . J Knee Surg 2008 ; 21 : 261 - 268 . 42 Zachary LS , Dellon AL . Progression of the zone of injury in experimental nerve injuries . Microsurgery 1987 ; 8
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treated with bone resection and tumor prosthesis. This upsurge is due to the development of new effective medical therapies, improving patients’ survival, associated with satisfactory functional results, and a low incidence of complications of this type of
