Acumed polarus proximal humeral plating system surgical technique. Intramedullary fixation has been thought as less invasive because it, compared with plate fixation, requires less extensive soft tissue dissection 2, 3. The acumed elbow plating system offers multiple fixation options for fractures of the platkng humerus, olecranon, and coronoid. While they are provided together for convenience, a plate and a nail should not be used on the same fracture. The design and placement of the polarus php helps minimize. Proximal humerus plating system is designed to provide intraoperative flexibility and efficiency to the surgical team. The acumed elbow plating system offers multiple fixation options for fractures of the distal humerus, olecranon, and coronoid.
Acumed believes that surgeons should have the ability to determine the. Internal fixation of proximal humeral fractures with a polarus humeral nail article pdf available in journal of orthopaedics and traumatology 93. If the patient is smallboned, the small proximal humeral plate plphsl or plphsr may be a better fit. We aimed to insert the lower two locking head screws across the calcar and into the inferior quadrant of the humeral head to protect against redisplacement from the disruption of the medial calcar. Proximal humeral fractures with a severe varus deformity. Acumen officials say that the device allows for a simplified operating room experience as it includes both plates and nails that use. Acumed offers a comprehensive selection of implants specifically designed to address a. The polarus php locking proximal humeral plate features a unique proximal screw trajectory to maximize fixation in the humeral head. William geissler orif proximal humerus fracture with anatomic gt. Polarus proximal humeral plate surgical technique 1 patient positioning the patient is placed in a beach chair position and the arm is draped to aid with fracture reduction. Clinical example using a, b, c, and e level screws 1 features anatomicallyshaped ten suture holes around the perimeter of the proximal end proximal locking holes accept 3. The humeral shaft extends distally away from the proximal head toward the elbow joint. Locking straight plate, locking distal clavicle plates and locking anterior clavicle plates. Internal fixation of proximal humeral fractures with a.
Werner1, hanspeter simmen1 and georg osterhoff1 abstract. Current concepts in locking plate fixation of proximal humerus fractures christoph j. Acumed, a hillsboro, oregon, orthopedic firm, is introducing its new polarus 3 solution, a method to treat proximal humerus fractures. It is important not to detatch the insertion of the tendon. Acumed php proximal humerus plate surgical technique. Distal anterolateral tibia plate distal medial tibia plate distal lateral femoral plate proximal lateral tibial plate the axsos locking plate system is designed to treat periarticular or intraarticular fractures of the proximal humerus, distal femur, proximal tibia, and the distal tibia. The twoplate construct creates a girderlike structure which strengthens the fixation. Acumed elbow plating system surgical technique intermedic. This plate addresses complex fractures of the proximal humerus. The system was designed in conjunction with shawn odriscoll, md, phd. Tensionrelieving rotator cuff sutures do not add stability to the repair of 3part proximal humerus fractures. Despite numerous available treatment strategies, the management of complex proximal humeral fractures remains demanding. Nowinski, mdc aindiana university school of medicine, indianapolis, in, usa bsports medicine and shoulder surgery, hawthorn medical associates, north dartmouth, ma, usa cdepartment of.
Elbow plating system acumed is a global leader of innovative orthopaedic and medical solutions. Acumed elbow plating system elbow plating system design surgeon. Anatomically contoured locking plates unique locking screw hole fracturespecific plating options radiolucent targeting systems lower extremity large fragment plate options. Nonunions of the proximal ulna lcp distal humerus plates dorsolateral plates with and without support medial plates all plates in a left and right version all plates in five lengths. Pdf internal fixation of proximal humeral fractures with. T2 proximal humeral nail is intended to provide temporary stabilization of various types of fractures, malunions and nonunions of the humerus. Olecranon plate provide fixation for both fractures and osteotomies in the proximal ulna. Proximal humeral fractures are the most common humeral fractures. Acumed upgrades humerus fracture device orthopedics this.
Proximal portion of the plate with 8 locking holes allows to set a maxi. Impaired bone quality and considerable comorbidities pose special challenges in the growing aging population. Establishing the appropriate position of proximal humerus. Proximal humerus fractures are commonly treated with open reduction and internal fixation with periarticular locking plates. The proximal end of the humerus has an enlarged head or cortex that includes the ball. Made of titanium alloy ti6al4v and treated with a type ii anodization, these plates are able to carry the loads that are required of them while remaining low profile. The elbow plating system offers precontoured, indicationspecific plates and includes a lowprofile olecranon plate design with a. Displaced or unstable fractures require open reduction and internal fixation. The acumed elbow plating system was the first to offer precontoured, parallel distal humerus plates. Olecranon plate provide fixation for both fractures and osteotomies in.
Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological humeral fractures, and impending pathological fractures. The design and placement of the polarus php helps minimize impingement and soft tissue irritation for the patient. No study to date has analyzed the relationship of the pmt with respect to appropriate locking plate positioning for. Proximal humeral locking plate cambridge orthopaedics. Proximal humeral fractures account for 4% to 5% of all fractures. The system is comprised of instrumentation to perform both plate and nail surgeries. Olecranonspecific plates with proximal extensions are widely thought to offer superior fixation of small proximal fragments but have distinct disadvantages. Increased stability can be gained from twoplate fixation of distal humerus fractures. Precontoured in three planes, the locking distal humerus plates offer multiple. Fixation of proximal humeral fractures with the polarus. With the polarus php locking proximal humeral plate, acumed has designed an advanced solution for repairing fractures of the proximal humerus. The acumed elbow plating system offers multiple fixation options for fractures. Each screw traverses the proximal humerus at a different angle, maximizing pull out strength and improving overall plate stability.
This study compared the geometry of proximal humerus locking plate s screw distribution, amount of bonescrew interface, and the volume the screws occupy within the humeral head, as well as how leaving the screws short of the articular. The comprehensive selection of implants was each designed to help minimize impingement and soft tissue irritation. The locking olecranon plates provide excellent fixation in the proximal ulna for both. This system offers an extensive selection of anatomically contoured plates, which are available in a variety of lengths and in two styles to. Periloc periarticular locked plating system for upper and. Product overview the acumed elbow plating system offers multiple fixation options for fractures of the distal humerus, olecranon, and coronoid, as well as osteotomies of the olecranon. The php is an anatomically designed, low profile, titanium locking plate and screw system. The polarus intramedullary nail acumed llc, hillsboro, or, usa is a stabilization device specialized for proximal humeral fixation. Create an entry site for access to the proximal humerus through a 10 mm standard deltoidpectoral incision made obliquely, in line with the deltoidpectoral interval. Proximal humerus locking plates were obtained from multiple vendors for research purposes. Proximal humerus plating system is designed to minimize the risk of some of the complications commonly associated with treating proximal humerus fractures by its design to. The acumed polarus php system, designed for 2, 3, and 4part proximal humerus fractures, aids in restoring patient anatomy while providing a rigid construct within the humeral head. When determining the placement and trajectory of the screws, acumed s goal was to capture the best bone available in the humeral head for maximum stability and pull out strength.
Enhancements to the previous system include precontoured posterolateral plates, left and right specific olecranon plates, and hexalobe screws. Periloc periarticular locked upper and lower extremity plates includes. Polarus proximal humeral plating system surgical technique. Plain radiograph shows ununited 2part fracture of proximal humerus in 80yearold woman 2 years after. Locking plate fixation for proximal humerus fractures. In line with our goal to bring to the market products that evolve and improve patient outcomes, acumed introduces three additional plate designs to the system. Olecranon plate 3 to 12 hole plates lateral plate 2 to 12 hole plates posterior lateral plate 2 to 14 hole. Proximal humerus plating system is indicated for fixation of fractures and fracture dislocations, fusions, osteotomies, and nonunions of the humerus, particularly in osteopenic bone. Definitive fixation was achieved using a proximal humeral locking plate philos plate. We are dedicated to developing products, service methods, and approaches that improve patient care. Elbow plating system brochure and surgical technique. Optilock upper extremity plating system proximal humeral. Humeral nail for fixation of proximal humeral fractures.
Medial column plate designed to offer fixation and compression of fractures of the distal humerus by extending down distally, or wrapping around, the medial epicondyle and extending up the condylar ridge. We performed open reduction and internal fixation with a tbuttress plate in 32 fractures of the proximal humerus with severe displacement andor fracture dislocation. Long screws in the lateral column plate are designed to interdigitate with screws from the medial column plate, providing a parallel construct for the stabilization of distal humerus fractures. Establishing the appropriate position the authors 2017. The acumed polarus proximal humeral plating php system, designed for 2, 3, and 4part proximal humerus fractures, aids in restoring patient anatomy while providing a rigid construct within the humeral head.
The following pages contain a step by step operative technique which illustrate the system. The polarus 3 proximal humerus plates are designed to fit an array. Fractures of the distal humerus, olecranon, and coronoid. The acumed polarus 3 solution includes plates, nails, screws, and accessories designed to address. The acumed polarus 3 solution has been designed to offer plate and nail options to treat proximal humerus fractures. The purpose of this study is to evaluate the biomechanical utility of the extended plate for treatment of olecranon fractures. The aos php is indicated for fractures, fracture dislocations, osteotomies, and nonunions of the proximal humerus. No mechanical data exist to demonstrate benefit of adding suture to a plate and screw construct for limiting fracture displacement. These low profile plates with polyaxial bushings provide freedom to direct the locking screws within the anatomical template, based on the fracture pattern and bone quality for better fixation. Polarus proximal humeral plating system intermedic. Our objective was to investigate the clinical and radiographic results of the internal fixation using polarus humeral nails for fractures of the proximal humerus. The humeral sutureplate is an anatomically designed polyaxial locking plate and screw system designed for the treatment of proximal humeral fractures. In most cases, the large proximal humeral plate plphgl or plphgr should be chosen. The acumed polarus 3 solution has been designed to offer plate and nail options to treat.
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