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Proximal Humerus Fracture with Plate (Deltopectoral Approach)

Master the osteosynthesis of the proximal humerus with plate from a surgical perspective 4K via deltopectoral.

Dr. Savio Chami
Médico Ortopedista
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Descrição

Master the treatment of proximal humerus fractures. This training offers a technical immersion in plate osteosynthesis via deltopectoral access, presented in 4K video from the surgeon's perspective, addressing the management of elderly patients with asymptomatic glenohumeral osteoarthritis.

Training Focus:

  • Osteosynthesis of proximal humerus fractures with plate.
  • Deltopectoral access: marking and dissection technique.
  • Management of the long head of the biceps and rotator cuff tendons (supraspinatus, subscapularis).
  • Fracture reduction strategies and intraoperative assessment.
  • Plate fixation and screw positioning.

Detailed Content:

  • Strategic Patient Positioning: Optimization of patient positioning for access and manipulation of the arm, including specific positions for access to key structures.
  • Precise Deltopectoral Dissection: Methodology for marking and blunt dissection, identifying muscle fibers and retracting the cephalic vein, minimizing tissue damage.
  • Advanced Management of Tendon Structures: Techniques for identification and tenotomy of the long head of the biceps and pectoralis major, and high-strength suture loops (Mason-Allen) in the supraspinatus and subscapularis for control of the tuberosities.
  • Guided Fracture Reduction: Systematic approach for fracture reduction using arm manipulation and loops, with anatomical landmarks such as the bicipital groove and fracture vertices for alignment and rotation control.
  • Effective Provisional Fixation: Use of Kirschner wire for provisional stabilization outside the plate implantation area.
  • Optimized Plating Technique: Protocols for plate positioning and sequential screw insertion, including the calcaneal screw as a fundamental guide for alignment.
  • Safe Drilling: Drilling methodology using a high-speed drill with low force to avoid perforation of the articular cartilage.
  • Fixation Enhancements: Performing tenodesis of the long head of the biceps and using synthetic bone graft as augmentation for biomechanical support.
  • Detailed Intraoperative Assessment: Radiographic analysis to verify plate height, fracture reduction, and plate centralization, ensuring proper screw distribution.

Included Material:

  • Detailed PDF: This PDF addresses the surgical treatment of proximal humerus fractures in elderly patients with asymptomatic glenohumeral osteoarthritis, detailing positioning, deltopectoral access, management of the long head of the biceps, tenotomies, exposure of tuberosities and rotator cuff, fracture reduction, fixation with plates and screws, tenodesis, and bone grafting.

Enhance your trauma surgery skills. Enroll now and master the techniques in the osteosynthesis of proximal humerus fractures.