The Reconstruction Twisted Wire-screws for Internal Fixation of Two- and Three-Part Fractures of the Proximal Humerus
THOSSART HARNROONGROJ, M.D.*, VICHAI VANADURONGWAN, M.D.*
Affiliation : * Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University. Bangkok 10700. Thailand.
Abstract Using the implants for internal fixation of the proximal humeral fractures has several problems which lead to complications and poor results of the fracture treatment. Because there is no suitable implant for internal fixation of the fracture. Therefore, the reconstruction twisted wire was developed in 1990 to improve the results of the fracture treatment. Between 1990 and 1994, the reconstruction twisted wire was used in 31 patients whose ages ranged from 18 to 90 years. Sixteen patients had displaced two-part surgical neck fractures. Fifteen patients had displaced three-part fractures. Postoperative follow-up ranged from two and a half years to five years and one month. All fractures healed. No avascular necrosis of the humeral head was observed at the follow-up. There was temporary subluxation of the shoulder joint in three patients and loosening of the screws in two patients with marked osteoporosis. One had a rupture of wire between the greater tuberosity and the shaft and loosening of the screw at the greater tuberosity and united with 10 degrees varus deformity. According to the functional scale proposed by Hawkins, 28 of the 31 patients achieved a "good" result and 3 patients had a "fair" result.
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