Method of reduction of proximal humeral fracture

摘要

A method for reducing and fixing fractures, for example, a proximal humeral fracture. A jacking device is releasably attached to a locking plate that presses against an inferior aspect of the head to rotate the head into anatomic alignment. Suture material is stitched into the soft tissue superior to the head and pulls the superior end of the head and guides and steers the head. The suture material is passed through suture holes in the superior end of the plate. The jacking device is positioned to hold the head in an anatomic neck/shaft angle, thereby allowing the head to be fixed to the locking plate. In one such embodiment, a swivel bushing in the plate receives the jacking device and allows the angle of the device to be adjusted as desired. To aid in the fluoroscopic visualization during surgery, a radiolucent retractor is used to avoid blocking the surgeon's view.

主权项

1. A method for reducing and fixing a fracture, said method comprising the steps of:
a) position a distal portion of a plate against a bone shaft with a portion of said plate proximate the fracture and a proximal portion of said plate proximate a head; b) provisionally secure said distal portion of said plate to said bone shaft; c) reduce said fracture by rotating said head out of varus and into alignment with said shaft by performing the steps of
c1) advancing an elongated member attached to said plate to push a first aspect of said head, andc2) pulling on suture material that is threaded through soft tissue attached to a second aspect of said head, said suture material threaded though openings in said proximal portion of said plate; and d) after said fracture is reduced, secure said proximal portion of said plate to said head and secure said distal portion of said plate to said bone shaft.