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Re: Comminuted fracture proximal humerus
послал George Thomas 21 Январь 2008, 22:46
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Dear Alex,
>>I agree that this reduction is not perfect. The gap may later result
with nonunion. Such or even better reduction can be reached without site
opening as you mentioned. Locking plates are positioned as less
invasive, why so long incision was - even longer than plate?
In the proximal humerus, the locking plate is generally introduced through an open incision of the type that I have used. The complex muscle attachments at the proximal end of the humerus, make it difficult to position the plate without opening.
>>You would use locking plate in the discussed case because it is somewhat
better comparatively to locked nail? Or just because you get accustomed
to use plates, or proximal humeral nails are not available around, or
because of some other reason?
Proximal humerus nails are available in India
The reason I prefer the locking plate for proximal humerus fractures is that the rotator cuff muscles have to be reattached, and that is possible with the plate and not the nail. I am not sure if they are detached in the present case. If they are not, then the nail is certainly a less invasive option.
Best regards,
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