Date: Sun, 23 Jun 2002 14:02:41 EDT

Subject: Proximal humerus blade plate

Does anyone on the list have experience/videos with the AO proximal humerus blade plate for fractures or nonunions?

Mike Messieh

Reply at: Orthopaedic Trauma Association forum

Date: Sun, 23 Jun 2002 19:15:23 +0100

From: chris wilson

One of my colleagues, Mr R L Williams, has extensive experience,and likes the device very much.

Regards

Chris Wilson
Knee and Trauma Surgeon
University Hospital
Cardiff, UK

Date: Mon, 24 Jun 2002 09:18:47 +0000

From: b.meinhard

Experience yes, videos no. It does work, but Synthes will soon have a proximal humeral locking plate designed along the lines of the LISS systems with which you are familiar. Look into it as well.

BPM

Date: Mon, 24 Jun 2002 10:56:12 -0400

From: Kevin Pugh

I don't have a video, but I have used it many times for both acute fractures and non-unions. It is well suited to proximal humerus fractures, especially those that extend down the shaft. It also has the advantages of a blade on osteopenic bone, and is fixed angle. Since it is cannulated, it also is easy to target into the proximal piece. I have fixed a few nonunions in very osteopenic shoulders with great success. I'm sure your Synthes rep will have a technique video or manual. Good device.

kp

Date: Mon, 24 Jun 2002 13:48:42 -0400

From: Sam Agnew

Mike It is a really nice implant, it has very specific fracture patterns though. Unlike the femoral blade plate application the insertion of the blade requires pre-reduction-stablization of the head component, as it can/will create a varus posture to the head-shaft angle as the humeral head "floats" in the gleno-humeral joint. Hold the head component in the desired posture before, and during insertion. The truss configuration ( Weber's text on special techniques - Springer Verlag publishers or JOTKrieg, et al 1995?)for screw placement is advisable as well. Placement in the cephalad-caudad direction is fairly precise as slight deviations cephalad to the depictions in the AO manual will result in implant-acromial impingement. I think that a locking proximal humeral plate will obviate the need for this in non-osteotomy procedures in the future. (my opinion) Check with your local rep for demo material and a sawbones to review/pre-op plan/practice

SGA

Samuel G. Agnew, M.D., FACS
Director, Orthopaedic Trauma
McLeod Regional Medical Center
901 East Cheves Street Suite 100
Florence, South Carolina 29506 


MEDLINE SEARCH "proximal humerus blade plate"

1:  Ring D, McKee MD, Perey BH, Jupiter JB. 
The use of a blade plate and autogenous cancellous bone graft in the treatment
of ununited fractures of the proximal humerus.
J Shoulder Elbow Surg. 2001 Nov-Dec;10(6):501-7.
PMID: 11743526 [PubMed - indexed for MEDLINE]

2:  Rehman S, Damron TA, Geel C. 
Humeral blade plate fixation of intercalary allografts and segmentally
comminuted proximal humeral fractures: a preliminary report.
Injury. 2000 Dec;31(10):783-8.
PMID: 11154748 [PubMed - indexed for MEDLINE]

3:  Hintermann B, Trouillier HH, Schafer D. 
Rigid internal fixation of fractures of the proximal humerus in older patients.
J Bone Joint Surg Br. 2000 Nov;82(8):1107-12.
PMID: 11132267 [PubMed - indexed for MEDLINE]

4:  Palmer SH, Handley R, Willett K. 
The use of interlocked 'customised' blade plates in the treatment of metaphyseal
fractures in patients with poor bone stock.
Injury. 2000 Apr;31(3):187-91.
PMID: 10704584 [PubMed - indexed for MEDLINE]

5:  Krettek C, Schandelmaier P, Tscherne H. 
[New developments in stabilization of dia- and metaphyseal fractures of long
tubular bones]
Orthopade. 1997 May;26(5):408-21. Review. German.
PMID: 9312700 [PubMed - indexed for MEDLINE]

6:  Kohler A, Simmen HP, Duff C, Kach K, Trentz O. 
[Osteosynthesis of subcapital humerus fractures with unconventional use of
implants]
Swiss Surg. 1995;(2):114-7. German.
PMID: 8590289 [PubMed - indexed for MEDLINE]

7:  Jupiter JB, Mullaji AB. 
Blade plate fixation of proximal humeral non-unions.
Injury. 1994 Jul;25(5):301-3.
PMID: 8034347 [PubMed - indexed for MEDLINE]

8:  Moda SK, Chadha NS, Sangwan SS, Khurana DK, Dahiya AS, Siwach RC. 
Open reduction and fixation of proximal humeral fractures and
fracture-dislocations.
J Bone Joint Surg Br. 1990 Nov;72(6):1050-2.
PMID: 2246287 [PubMed - indexed for MEDLINE]

9:  Sehr JR, Szabo RM. 
Semitubular blade plate for fixation in the proximal humerus.
J Orthop Trauma. 1988;2(4):327-32. Review.
PMID: 3074161 [PubMed - indexed for MEDLINE]