Pectoralis Major Pedicle Bone Graft For 4-Part Proximal Humerus Fractures

Study Overview
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Brief Summary
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The investigators tried to evaluate the results of our patients who underwent plate osteosynthesis with vascularized pectoralis major graft for the treatment of 4-part proximal humerus fractures.

Detailed Description
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The risk of avascular necrosis, nonunion, or malunion is high in 4-part fractures which is the most serious form of proximal humerus fracture.Bone impaction grafts are an important treatment option when osteosynthesis with LCP plate is desired especially for osteoporotic patients. Fibular strut grafts (FSGs) and autologous iliac bone impaction grafts (AIBIGs), which are frequently used to provide mechanical support, may have the risk of nonunion in osteoporotic bone whose vascular support is weakened due to fracture. Bone pedicled pectoralis major grafts may prevent varus collapse, nonunion and avascular necrosis.

Official Title
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Pectoralis Major Pedicle Bone Graft For 4-Part Proximal Humerus Fractures

Conditions
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Patients With Closed Neer Type 4 Proximal Humerus Fractures

Intervention / Treatment
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* Procedure: Pectoralis Major Pedicle Bone Graft


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients aged 50-75 years with closed Neer type 4 proximal humerus fractures Exclusion Criteria: Patients under 50 and over 75 years of age, Patients with pathological fractures, Patients with neurological deficits such as brachial plexus injury Patients with previous shoulder surgery

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Patients with closed Neer type 4 proximal humerus fractures<br>patients aged 50-75 years with closed Neer type 4 proximal humerus fractures | Procedure: Pectoralis Major Pedicle Bone Graft<br>* It is aimed to restore the integrity of the medial cortex with the bone pedicle from the insertion region of the pectoralis major muscle in middle-aged patients with Neer type 4 proximal humerus fractures. Researchers aim to reduce the risk of avascular necrosis with a vascular living bone tissue, as well as providing mechanical support with this method. The investigators aim to reduce the risk of avascular necrosis with a vascular living bone tissue, as well as providing mechanical support with this method.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patients were evaluated in terms of functional shoulder results and radiographic union | Constant and American shoulder and elbow surgeons scores were used for functional assesment | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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proximal humerus, closed, fracture, bone pedicled graft