E.P. KOSTIV¹, D.A. NEVEZHKIN^1, 2, E.E. KOSTIVA¹, R.E. KOSTIV^1, 2, E.S. KONDRATIEVA¹

 ¹Pacific State Medical University, Vladivostok

²Vladivostok Clinical Hospital No. 2, Vladivostok

  Contact details:

Kostiv E.P. — MD, Professor, Director of the Institute of Surgery

Address: 2 Prospekt Ostryakova, Vladivostok, Russian Federation, 690002, e-mail: plastina@rambler.ru

 The purpose — to conduct a comparative analysis of the results of surgical treatment of patients with bifocal and polyfocal fractures of the proximal humerus on the background of osteoporosis.

Material and methods. In 2017–2020, 96 patients with fractures of the proximal humerus aged 55 to 88 years (average age 64 ± 2.3 years) were operated on in Vladivostok Clinical Hospital No. 2. The main group included 77 patients, the control group included 19 patients who underwent internal osteosynthesis according to the authors’ technique: interfragmental compression combined with fixation with a lockable plate.

Results. The best results of the reposition were achieved in cases of earlier surgical intervention in both groups of patients. Complications (33.3%) were noted in the main group, including aseptic necrosis of the shoulder head and non-fusion of fractures. There were no similar complications in the control group. A significant difference in functional results in the studied groups of patients is explained by a number of reasons. Compression stable osteosynthesis allowed most patients to begin early active rehabilitation.

Conclusion. Predictors of complications in the surgical treatment of patients with fractures of the proximal shoulder are the bone density, the choice of a fixator and the method of osteosynthesis.When evaluating the results of treatment in the main group of patients, a clear advantage of the developed method of osteosynthesis is shown in comparison with the standard use of a PHILOS-type lockable plate.

Key words: osteosynthesis, interfragmental compression, comminuted fractures of the proximal humerus, osteoporosis.

(For citation: Kostiv E.P., Nevezhkin D.A., Kostiva E.E., Kostiv R.E., Kondratieva E.S. New possibilities of bone osteosynthesis in comminuted fractures of the proximal humerus in patients with osteoporosis. Practical medicine. 2022. Vol. , № , P.)