The Bilboquet device for fractures of the proximal humerus in the elderly.

DOURSOUNIAN L | CANDELIER G | WERTHER JR | JACQUOT F | GRIMBERG J

Seance of wednesday 08 march 2006 (pas de sujet Principal)

Abstract

We describe a novel internal fixation device, and report on 61 patients(mean age: 76.8 years) whose proximal humeral fractureswere managed with this technique. The two-part titanium implantconsists of a circular staple impacted into the humeral head cancellousbone, and a spigoted diaphyseal stem that inserts into the staple“cup”. Of the 61 cases reviewed, 10 had two-part fractures, 27 hadthree-part, and 24 had four-part fractures. In the ten two-part fracturepatients, mean active forward elevation was 120°. The resultswere: 6 excellent, 2 good, and 2 fair. In the 27 three-part fracturepatients, mean active forward elevation was 120°. The results were:13 excellent, 9 good, and 5 fair. In the 24 four-part fracture patients,mean active forward elevation was 94°; there were 3 excellent, 8good, 8 fair, and 5 poor results. There were 13 cases of avascularnecrosis, and two cases of tuberosity nonunion. Only three casesneeded conversion to hemiarthroplasty. This technique should simplifythe surgery of these fractures in the elderly, and reduce theneed for arthroplasty.