Internal Splinting with a Balloon-Shaped Allogenic Cancellous Bone Graft for Proximal Humerus Comminuted Fracture

Background/Purpose: Mechanical support of the inferomedial region of the proximal humerus is important for maintaining fracture reduction in comminuted fracture of the proximal humerus. We use the balloon shape of allograft cancellous bone to provide medial column support and summarize the result. Patients and methods: We included 25 patients (12 men and 13 women with a mean age of 55 years) with 3-and 4-part humerus fractures, who underwent internal splinting from July 2008 to September 2012, in our study. We used a T-plate with internal splinting (balloon shaped allogenic cancellous bone) to fix the proximal humerus fracture. Radiographs were periodically checked half, 1, 2, 4, 6, 12 and 24 months months after surgery. The shoulder function was evaluated with Constant-Murley score one year after surgery. Results: Eighteen (72%) of humerus fractures healed after 12 months. The following complications were observed:2 case of screws pull out (8%), 1 case of nonunion (4%), 2 cases of avascular necrosis (8%), and 2 cases of varus collapse (8%). There were no cases of infection or nerve injury. The median Constant-Murley score at one year was 70 points. Discussion and conclusion: Medial support is important to provide stability after proximal humerus fractures.. We used a balloon-shaped allogenic cancellous bone graft to provide (1) a more balanced medial support, (2) material for screw purchase, and (3) a biologic effect for bone healing. It should be another treatment option for patients with comminuted proximal humerus fractures.