General anaesthesia combined with a regional block was used and a beach chair position was given to all the patients. Early results in the treatment of proximal humeral fractures. You should mark the skin before any local anesthetic. Instruction by a surgeon experienced in handling this product is. Philos and philos long surgical technique depuy synthes 3 philos instruments outer sleeve restricted drill bit length probe quick steps for insertion in good bone stock 1. Pdf philos plate fixation for proximal humeral fractures. The present study was undertaken to evaluate the results to date of open reduction and internal fixation of fractures of the proximal humerus using the philos plate stratec, uk. The art of surgery paperback january 1, 1987 by gary g wind author visit amazons gary g wind page.
Minimal invasive plate osteosynthesis mipo technique using. Health, general evidencebased medicine usage fractures care and treatment fractures injuries humerus health aspects internal fixation internal fixation in fractures. Purchase handbook of surgical technique 1st edition. The new sections on panoramic laparoscopic cadaveric anatomy of the inguinal area, kugel hernia repair, laparoscopic inguinal hernia repair, transhiatal esophagectomy. Philos system is an anatomical lcp plating system for proximal humerus fracture fixation. The plate joystick technique to reduce proximal humeral fractures and nonunions. Management of proximal humerus fracture with locking. A prospective study was conducted in our institution from july 2011 to may 20 of a total of 60 patients with proximal humerus fractures. Shawn odriscoll, md, phd mayo foundation, ken yamaguchi, md washington university, barnes jewish hospital graham king, md, msc university of western ontario 2 table of contents table. Operative technique 10 preoperative planning 10 implant selection 10 patient positioning 11 fracture reduction 12 special techniques for fracture reduction incision 14 entry point 16 opening the cortex 16 preparation of medullary canal 17 assembly of targeting device 23 nail insertion 26 lag screw positioning using one shot device 28. Aotk proudly launches the 20 edition of the aotk system innovations magazine, which details 15 new implants and instruments for use in trauma, spine, cmf, and veterinary surgery, and includes. Philos plate osteosynthesis in metaphyseal fractures of the distal. Concise and easy to read, it uses a highly illustrated, stepbystep approach to. Approach the approach must normally be lengthened because of the plate.
Philos plate fixation for displaced fractures of the. Femoral canal preparation use the box osteotome and canal finder for initial entry into femoral canal. Surgical management of proximal humerus fracture by joshis external stabilizing system. Surgical technique and results utilizing three shoulder scores. Surgical management of proximal humerus fracture by joshi.
The kwire should be inserted considering that the centerline of the hinge plate will be placed approximately at 6. Now, more than ever, surgical anatomy and technique is a must have for every resident and general surgeon. Surgical technique definition of surgical technique by. New trends in the treatment of proximal humerus fractures. From the renowned centers for surgical anatomy and technique of emory university, here is the revised and updated, defintive memory refresher for the practicing surgeon and the surgical resident entering the operating room. The proximal humerus internal locking system philos youtube. Highly readable, accurate, and comprehensive, it clearly covers the nuts and bolts of surgical techniques in a stepbystep format that makes it easy to effectively apply basic principles to clinical practice. This is a good time to remind you of your good body position. Orthopedic trauma incl pediatrics your digital gateway to expertise, education, and innovation.
Long term results of philos plating and percutaneous kwire. Moonot et al jbjs br 2007 32 patients with 3 or 4 part treated with philos plate 31 of 32 united 2732 86% excellent or satisfatory results 532 16% poor results 1 patient avn and non union. Expert consult online and print, 1e provides beautiful handdrawn anatomic images along with clear instructions on the performance of each operation. Position the plate either visual or with positioning kirschner wire 4. Find all the books, read about the author, and more. Plate on plate osteosynthesis for the treatment of. Surgical technique synonyms, surgical technique pronunciation, surgical technique translation, english dictionary definition of surgical technique. This surgical technique is for a l4l5 operative site. Ijsst answers the complete information needs for practitioners concerned with evolution in.
Surgery was performed under general anaesthesia, patient in supine position with a small sand bag under the shoulder. Handbook of surgical technique 97803234620 us elsevier. In this group 12 patients had twopart fracture, 14 patients had threepart fracture and four patients had four part fracture. Philos plate fixation for displaced fractures of the proximal. Ao surgery reference is a resource for the management of fractures, based on current clinical principles, practices and available evidence. Plate on plate osteosynthesis for the treatment of nonhealed.
For optimal plate positioning, insert two positioning kirschner wires 24 mm lateral to the bicipital groove and. Although several studies have repeatedly emphasized that philos plating gives better functional outcomes for fracture proximal humerus and that many studies have speculated and concluded various risk factors for failure or poor functional outcomes, none of them gives a clear idea about the important parameters of the biomechanics of the glenohumeral joint and their restoration. The results of plate fixation have been mixed, with worse results for three and four part fractures. It features a true anatomical reconstruction latitude total elbow prosthesis of the joint, modular components, and is adaptable to a wide range of indications. Fixation of proximal humerus fractures using the philos. Surgical management of proximal humerus fracture by joshis. The art of the surgical technique plastic surgery key. Abstract controversy persists concerning the preferred treatment of displaced fractures of the proximal humerus.
Failures of operative treatment of comminuted fractures of proximal humerusin in. The other screws in the new plate were used as best suited the fracture. Other skin incisions will be placed adjacent to anatomic structures to hide the scar. Surgical technique prepare acetabulum if acetabular reconstruction is required, prepare the acetabulum using the surgical technique for the intended acetabular component. Philos proximal humerus plate long specification, uses. Plate options include 1, 2 and 4hole plate configurations as determined by the patients. The clinical experience is received at list names of clinical rotation sites. The surgical approaches commonly used for mipo in proximal humerus fractures are the transdeltoid lateral approach, anterolateral approach, and deltopectoral approach 9.
Evaluation of clinical and radiological outcome of fracture. New surgical techniques and surgical site infections. Thoroughly revised and with dozens of new illustrations, the fourth edition continues the tradition of providing a concise, accessible, and generously illustrated memory refresher for both novice and experienced clinicians. The carefully outlined and practical explanations of anatomy and how it pertains to general surgery will help the general surgeon in avoiding complications and in developing masterful surgical technique. Plate fixation of proximal humeral frx wheeless textbook. Plate fea tures combined with ao technique create an environment for bone healing, expediting. Textbook of operative techniques in upper extremity sports injuries.
Hessmann m, baumgaertel f, gehling h, klingelhoeffer i, goetzen l. Please consult the surgical technique philos and philos long dsemtrm08150449 for detailed information on the implant and its indications. Examples of the relationship between surgeonspecific volume and death associated with cabg procedures have been published 68. However, the following points should be considered in particular.
Plate fixation of proximal humeral fractures with indirect reduction. Fixation of proximal humerus fractures using the philos plate. Ijsst answers the complete information needs for practitioners concerned with evolution in research related to clinical surgery. Minimal invasive plate osteosynthesis mipo technique. Treatment of proximal humerus fractures using philos plate ncbi. Exercises for the first six weeks martin kelley, dpt of penn rehab duration. Implant assembly select the appropriate peek spacer footprint and height and the plate type zeroplate, halfplate or fullplate of the same height. From patient preparation to hand washing, from equipment to basic surgical procedures, this highly practical manual by drs. Aotk system innovations 1 20 by ao foundation issuu. Philos plate fixation for displaced fractures of the proximal humerus. Suture technique and closure instrumentation the latitude surgical technique has been developed in conjunction with. Proper surgical procedure is the responsibility of the medical professional. The aims of study were to evaluate the outcomes of our less invasive plating technique using a modified anterolateral approach in proximal humerus fracture treatment.
The majority of incisions will be placed in natural skin creases as in the upper lid skin crease for ptosis and blepharoplasty operations. Operative techniques are furnished as an informative guideline. The philos plate is suitable for the majority of fractures providing that the correct surgical technique is used. With the invention of locked plating, a novel biomechan. Surgical technique for open reductioninternal fixation of an.
In this surgical technique, the type of phlp used is the philos plate proximal humeral internal locking system. The duration of the latency period is to be determined by the surgeon. The book and accompanying videos provide good value and should be helpful for medical students and possibly some firstyear residents. Reviewed by carol scottconner, md, phd, mba university of iowa hospitals and clinics. Specifically written for the surgical technologist student and practitioner, the 3rd edition maintains a user friendly format and readability. Treatment of proximal humerus fractures using philos plate. Do you want to use the redesigned ao sr like an app. Unthreaded freedom holes freehand placement of screws. For information on fixation principles using conventional and locked plating techniques. At the back table, assemble the plate assembly driver onto the ratcheting torque handle, and. The student functions under the supervision of the instructor, staff surgical technologists, or.
Proximal humerus fractures operated with philos plate. We offer one of the worlds most comprehensive portfolios of orthopaedic products and services in the areas of joint reconstruction, trauma, spine, sports medicine, craniomaxillofacial, power tools and biomaterials. The platejoystick technique to reduce proximal humeral fractures and nonunions. Evaluation of clinical and radiological outcome of. Each surgeon must evaluate the appropriateness of a technique based on his or her personal medical credentials and experience. We described a surgical method for osteosynthesis and reported the resultant strength after. Initial location for placement of the hinge plate is achieved by inserting a guiding kwire to localize the growth plate under fluoroscopic imaging carm. In all cases the existing plate was left and the new one placed over the existing. A power drill and standard jacobs chuck are required. Durango standalone alif system surgical technique guide 5 2. Learn the open reduction and internal fixation of proximal humeral physeal fracture using synthes philos plate surgical technique with step by step instructions on orthoracle. Shoulder arthroplasty system tsa surgical technique.
Kavoussi, provides students, residents, and clinicians with a firm foundation in the core techniques and skills required for the operating room environment. Table of contents editorial 1 trauma, upper extremity 2 philos augmented. The respective surgical technique, which addresses fixation failure and. Philos plate fixation for proximal humeral fractures article pdf available in journal of orthopaedic surgery hong kong 171. Generations of residents and general surgeons have relied upon and worn out their copies of surgical anatomy and technique.
Surgical technique prior to performing this technique, please consult the instructions for use documentation provided with the device for additional health and safety information, including indications, contraindications, warnings, and precautions. The purpose of this paper is to present our technique for the treatment of periplate fractures. Group 1 included 30 patients 20 males and 10 females with mean age of 65 years who were treated with orif with philos plate. A novel hybrid fixation technique for osteosynthesis of isolated greater. Outcomes in patients of fracture of surgical neck humerus treated with proximal humerus interlocking osteosynthesis philos plate fixation they concluded that incidence of nonunion is very less with philos fixation and the incidence of infection reduced to a lower level due to skill of proper anatomical exposure and experience of the. Our elearning platform contains high resolution images and a certified cme of the open reduction and internal fixation of proximal humeral physeal fracture using synthes philos plate surgical procedure. Indications need sufficient bone quality always attempt in young. Many oculoplastic procedures require skin marking as a guide to incision placement. Long term results of philos plating and percutaneous k. Group 1 patients with proximal humerus fractures were treated with open reduction and internal fixation orif with philos plate. Timberline mpf lateral systemsurgical technique guide 11 figure 6 plate and interbody assembly figure 7 inserter attachment step 6 assemble the device by selecting the appropriate size peekoptima interbody and the corresponding plate. Fixation with the philos plate is a near ideal technique with a high union rate in the treatment of proximal humeral fractures.
Range longer plates cover a wider range of fractures. The most commonly used implant reported was the philos plate. At the back table, assemble the plate assembly driver onto the ratcheting torque handle, and then assemble the plate to the peek spacer. Phillos proximal humerus locked plate proximal humerus multiple locked plate.
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