Measurement of screw length through drilling technique in osteosynthesis of the proximal humerus fractures
Cem Coşkun Avcı1, Deniz Gülabi2, Necdet Sağlam1, Tuhan Kurtulmuş1, Gürsel Saka1
1Ümraniye Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye
2Kartal Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye
Keywords: Complication; fracture fixation; internal; shoulder fracture; surgery.
Objectives: This study aims to investigate the efficacy of screw length measurement through drilling technique on the reduction of intraarticular screw penetration and fluoroscopy time in osteosynthesis of proximal humerus fractures.
Patients and methods: Between January 2008 and June 2012, 98 patients (34 males, 64 females; mean age 64.4 years; range 35 to 81 years) who underwent osteosynthesis using locking anatomical proximal humerus plates (PHILOS) in our clinic with the diagnosis of Neer type 2, 3 or 4 were included. Two different surgical techniques were used to measure proximal screw length in the plate and patients were divided into two groups based on the technique used. In group 1, screw length was determined by a 3 mm blunt tipped Kirschner wire without fluoroscopic control. In group 2, bilateral fluoroscopic images for each screw at least were obtained.
Results: Intraarticular screw penetration was detected in five patients (10.6%) in group 1, and in 19 patients (37.3%) in group 2. The mean fluoroscopic imaging time was 10.6 seconds in group 1 and 24.8 seconds in group 2, indicating a statistically significant difference.
Conclusion: Screw length measurement through the drilling technique significantly reduces the intraarticular screw penetration and fluoroscopy time in osteosynthesis of proximal humerus fractures using PHILOS plates.