Humeral Osteosynthesis
What is humeral osteosynthesis?
What is humeral osteosynthesis?
The humerus is the long bone in the arm that extends from the shoulder to the elbow. This bone can suffer fractures in its upper region (at the shoulder) to its lower region (at the elbow) as well as in the intermediate region known as the diaphysis. Fractures of the humerus, when they present a certain degree of deviation or joint involvement, may benefit from surgical treatment to correct the alignment and fix it with metal implants, a procedure called osteosynthesis.
Which humerus fractures require osteosynthesis?
Which humerus fractures require osteosynthesis?
Proximal humerus fractures are defined as those that occur in the upper third of the humerus, which involves the shoulder joint. Although most can be treated conservatively (without surgery), misaligned fractures or those with multiple fragments may benefit from surgical treatment.
When reconstruction is possible, given the bone quality, age and functional requirements of the patient, osteosynthesis of the humerus can restore function and avoid complications of avascular necrosis (destruction of cartilage due to lack of blood supply) or consolidation of fragments in unsuitable positions.
In fractures of the diaphyseal humerus (middle third), most can also be treated without surgery. However, misaligned or unstable fractures may require osteosynthesis to improve the position of the fragments and bone consolidation.
Fractures of the lower third often involve the elbow joint and are mostly treated surgically, given the risk of instability and functional impairment.
How is humerus osteosynthesis performed?
How is humerus osteosynthesis performed?
In proximal humerus fractures, there are two main types of implants that are used – plates and pins. Proximal humerus plates are inserted through an incision in the shoulder region and, after the fracture has been reduced, the plate is used in conjunction with screws to ensure stable fixation of the fragments. Pins are another type of device, which are inserted through a small upper incision and traversed through the medullary canal. Their stability is ensured by screws placed percutaneously.
The preference for each type of implant depends on the fracture pattern and factors related to the patient and the surgeon’s experience.
In mid-third fractures, plates or pins may also be used to stabilize and promote consolidation. Again, the type of fracture and certain characteristics of the patient or the surgeon’s preference will be key in the choice.
For distal third fractures, the most common approach is fixation with plates and screws.
What are these materials made of?
What are these materials made of?
In general, metal implants used for humeral osteosynthesis are made from steel or titanium metal alloys, with some carbon options currently available.
These materials are not incompatible with carrying out additional tests, such as resonance, nor are they identifiable by metal detectors commonly used at security checkpoints.
