International Orthopaedics

, Volume 28, Issue 6, pp 333–337 | Cite as

Valgus impacted proximal humeral fractures and their blood supply after transosseous suturing

  • Andreas M. PanagopoulosEmail author
  • P. Dimakopoulos
  • M. Tyllianakis
  • D. Karnabatidis
  • D. Siablis
  • A. X. Papadopoulos
  • E. Lambiris
  • P. Kraniotis
  • G. Sakellaropoulos
Original Paper


We treated 16 patients (11 women and five men, average age 45 years), all having four-part valgus impacted fractures of the proximal humerus, with transosseous suturing. All had preoperative angiography performed 6–12 h after admission. The average impaction angle was 43°, and the mean lateral displacement of the humeral head was 1.4 mm. Postoperative angiography was performed 8–10 weeks after the operation followed by digital image processing using the segmentation technique. No statistically important reduction in the length and area of large (>0.5 mm) vessels was seen. Union was confirmed by the reduction in the length and area of small vessels (<0.5 mm). At a mean follow-up of 40 months, avascular necrosis was only found in one patient. The average Constant–Murley score was 87 (67–100) points, whereas the functional score in comparison with the unaffected shoulder was 94% (89–100%). Despite the small number of patients, transosseous fixation seems to preserve the remaining blood supply of the humeral head.


Rotator Cuff Humeral Head Lateral Displacement Proximal Humerus Proximal Humeral Fracture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Nous avons traité 16 malades (11 femmes et 5 hommes, d’âge moyen 45 ans), présentant une fracture de l’humérus proximal à 4 fragments, impactée en valgus, avec suture trans-osseuse. Tous avaient une angiographie préopératoire exécutée 6 à 12 heures après l’admission. L’angle moyen de l’impaction était 43° et le déplacement latéral moyen de la tête humérale 1.4 mm. L’angiographie postopératoire a été exécutée 8–10 semaines après l’opération, en utilisant la technique de la segmentation. Aucune réduction statistiquement importante dans la longueur et le territoire des vaisseaux de plus de 0.5 mm n’a été noté. L’union a été confirmée par la réduction de la longueur et du territoire des petits vaisseaux (<0.5 mm). À un suivi moyen de 40 mois, une seule nécrose avasculaire a été trouvé. Le score de Murley Constant moyen était 87 (67–100) points alors que le score fonctionnel en comparaison de l’épaule non affectée était 94% (89–100%). En dépit du petit nombre de malades étudiés, la fixation trans-osseuse paraît conserver la vascularisation restante de la tête humérale.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Andreas M. Panagopoulos
    • 1
    Email author
  • P. Dimakopoulos
    • 1
  • M. Tyllianakis
    • 1
  • D. Karnabatidis
    • 2
  • D. Siablis
    • 2
  • A. X. Papadopoulos
    • 1
  • E. Lambiris
    • 1
  • P. Kraniotis
    • 2
  • G. Sakellaropoulos
    • 3
  1. 1.Department of OrthopaedicPatras University HospitalRio-PatrasGreece
  2. 2.Department of Interventional RadiologyPatras University HospitalRio-PatrasGreece
  3. 3.Department of Medical PhysicsPatras University HospitalRio-PatrasGreece

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