The Effect of Calcar Screw Use in Fractures of the Proximal Humerus

Mustafa  Elsagier; Mohamed Mahmoud

المؤلفون

Mustafa Elsagier Head Division of orthopaedic Surgery Faculty of Medicine Misurata University and Misurata Medical Center Misurata Libya.
Mohamed Mahmoud Department of Orthopaedics Tripoli Medical Centre Libya

الكلمات المفتاحية:

Proximal humerus fracture، Calcar screw، Locking plate، Neck-shaft angle، Fixation failure

الملخص

Background:
Proximal humerus fractures are common in elderly patients. Locking plates offer stable fixation, but loss of reduction and varus deformity still occur, especially with poor medial support.

Methods:
25 patients treated with PHILOS plates were studied. Calcar screws were used in some cases. Radiographs were assessed for neck-shaft angle and calcar screw position. Shoulder function was measured using the Oxford Shoulder Score.

Results:
91% of optimally placed calcar screws were associated with neck-shaft angles between 130°–150°. Malposition rate was 32%. Fixation failure occurred in 3 patients without calcar screws; none occurred in the calcar screw group.

Conclusion:
Use of calcar screws and achieving a neck-shaft angle between 130°–150° reduces fixation failure. Proper placement improves medial support and patient outcomes.

المراجع

. Launonen AP, Lepola V, Saranko A, Flinkkila T, Laitinen M, Mattila VM *. Epidemiology of proximal humerus fractures. Arch Osteoporos. 2015; 10:209.

. .Schumaier A, Grawe B. Proximal humerus fractures: evaluation and* management in the elderly patient. Geriatr Orthop Surg Rehabil. 2018;9: 2151458517750516

. *Dilisio MF, Nowinski RJ, Hatzidakis AM, Fehringer EV. Intramedullary nailing of the proximal humerus: evolution, technique, and results. J Shoulder Elb Surg. 2016;25: e130–8.

. Gracitelli MEC, Malavolta EA, Assuncao JH, Ferreira Neto AA, Silva JS, Hernandez AJ. Locking intramedullary nails versus locking plates for the treatment of proximal humerus fractures. Expert Rev Med Devices. 2017;14: .9–733

. Wang L, Chen Y, Wei H. Percutaneous torsional shaping with long-type PHILOS plate for the treatment of upper and middle humerus fractures: a preliminary report. Orthop Biomech Mater Clin Study. 2011; 8:14–8.

. Aksakal B, Gurger M, Say Y, Yilmaz E. Biomechanical comparison of straight DCP and helical plates for fixation of transverse and oblique bone fractures. Acta Bioeng Biomech. 2014; 16:67–74.

. Aksu N, Karaca S, Kara AN, Isiklar ZU. Minimally invasive plate osteosynthesis