Philos and philos long surgical technique depuy synthes 3 philos instruments outer sleeve restricted drill bit length probe quick steps for insertion in good bone stock 1. Instruction by a surgeon experienced in handling this product is. Abstract controversy persists concerning the preferred treatment of displaced fractures of the proximal humerus. Surgical technique for open reductioninternal fixation of an. Ijsst answers the complete information needs for practitioners concerned with evolution in research related to clinical surgery. Operative technique 10 preoperative planning 10 implant selection 10 patient positioning 11 fracture reduction 12 special techniques for fracture reduction incision 14 entry point 16 opening the cortex 16 preparation of medullary canal 17 assembly of targeting device 23 nail insertion 26 lag screw positioning using one shot device 28. Many oculoplastic procedures require skin marking as a guide to incision placement.
Operative techniques are furnished as an informative guideline. The new sections on panoramic laparoscopic cadaveric anatomy of the inguinal area, kugel hernia repair, laparoscopic inguinal hernia repair, transhiatal esophagectomy. This is a good time to remind you of your good body position. Group 1 included 30 patients 20 males and 10 females with mean age of 65 years who were treated with orif with philos plate. Examples of the relationship between surgeonspecific volume and death associated with cabg procedures have been published 68. Failures of operative treatment of comminuted fractures of proximal humerusin in. In all cases the existing plate was left and the new one placed over the existing. The surgical approaches commonly used for mipo in proximal humerus fractures are the transdeltoid lateral approach, anterolateral approach, and deltopectoral approach 9. Plate options include 1, 2 and 4hole plate configurations as determined by the patients. The results of plate fixation have been mixed, with worse results for three and four part fractures. Phillos proximal humerus locked plate proximal humerus multiple locked plate. From patient preparation to hand washing, from equipment to basic surgical procedures, this highly practical manual by drs.
Original article by journal of evolution of medical and dental sciences. Surgical technique and results utilizing three shoulder scores. A prospective study was conducted in our institution from july 2011 to may 20 of a total of 60 patients with proximal humerus fractures. Table of contents editorial 1 trauma, upper extremity 2 philos augmented.
The book and accompanying videos provide good value and should be helpful for medical students and possibly some firstyear residents. The present study was undertaken to evaluate the results to date of open reduction and internal fixation of fractures of the proximal humerus using the philos plate stratec, uk. Radio graphically union, plate fixation was associated with minimal deformity implant failure, reflex sympathetic dystrophy and a vascular necrosis were observed in very few. Learn the open reduction and internal fixation of proximal humeral physeal fracture using synthes philos plate surgical technique with step by step instructions on orthoracle. Surgical technique prior to performing this technique, please consult the instructions for use documentation provided with the device for additional health and safety information, including indications, contraindications, warnings, and precautions. For optimal plate positioning, insert two positioning kirschner wires 24 mm lateral to the bicipital groove and. Unthreaded freedom holes freehand placement of screws. The art of surgery paperback january 1, 1987 by gary g wind author visit amazons gary g wind page.
The philos plate is suitable for the majority of fractures providing that the correct surgical technique is used. New trends in the treatment of proximal humerus fractures. The most commonly used implant reported was the philos plate. Philos proximal humerus plate long specification, uses.
Durango standalone alif system surgical technique guide 5 2. Management of proximal humerus fracture with locking. Outcomes in patients of fracture of surgical neck humerus treated with proximal humerus interlocking osteosynthesis philos plate fixation they concluded that incidence of nonunion is very less with philos fixation and the incidence of infection reduced to a lower level due to skill of proper anatomical exposure and experience of the. For information on fixation principles using conventional and locked plating techniques. Handbook of surgical technique 97803234620 us elsevier. Surgery was performed under general anaesthesia, patient in supine position with a small sand bag under the shoulder. Surgical technique guide the latency period is the time period between the initial surgery when the distraction device is placed and when the distraction begins. Although several studies have repeatedly emphasized that philos plating gives better functional outcomes for fracture proximal humerus and that many studies have speculated and concluded various risk factors for failure or poor functional outcomes, none of them gives a clear idea about the important parameters of the biomechanics of the glenohumeral joint and their. General anaesthesia combined with a regional block was used and a beach chair position was given to all the patients. Expert consult online and print, 1e provides beautiful handdrawn anatomic images along with clear instructions on the performance of each operation. We described a surgical method for osteosynthesis and reported the resultant strength after. Outcomes of open reduction and internal fixation of.
Ijsst answers the complete information needs for practitioners concerned with evolution in. Position the plate either visual or with positioning kirschner wire 4. Each surgeon must evaluate the appropriateness of a technique based on his or her personal medical credentials and experience. Ao surgery reference is a resource for the management of fractures, based on current clinical principles, practices and available evidence.
The other screws in the new plate were used as best suited the fracture. Philos plate fixation for displaced fractures of the proximal. Long term results of philos plating and percutaneous k. We offer one of the worlds most comprehensive portfolios of orthopaedic products and services in the areas of joint reconstruction, trauma, spine, sports medicine, craniomaxillofacial, power tools and biomaterials. Kavoussi, provides students, residents, and clinicians with a firm foundation in the core techniques and skills required for the operating room environment. Long term results of philos plating and percutaneous kwire. This surgical technique is for a l4l5 operative site. Timberline mpf lateral systemsurgical technique guide 11 figure 6 plate and interbody assembly figure 7 inserter attachment step 6 assemble the device by selecting the appropriate size peekoptima interbody and the corresponding plate. Plate on plate osteosynthesis for the treatment of nonhealed.
Although several studies have repeatedly emphasized that philos plating gives better functional outcomes for fracture proximal humerus and that many studies have speculated and concluded various risk factors for failure or poor functional outcomes, none of them gives a clear idea about the important parameters of the biomechanics of the glenohumeral joint and their restoration. Surgical technique prepare acetabulum if acetabular reconstruction is required, prepare the acetabulum using the surgical technique for the intended acetabular component. Specifically written for the surgical technologist student and practitioner, the 3rd edition maintains a user friendly format and readability. From the renowned centers for surgical anatomy and technique of emory university, here is the revised and updated, defintive memory refresher for the practicing surgeon and the surgical resident entering the operating room. Femoral canal preparation use the box osteotome and canal finder for initial entry into femoral canal. Philos plate fixation for proximal humeral fractures article pdf available in journal of orthopaedic surgery hong kong 171. Generations of residents and general surgeons have relied upon and worn out their copies of surgical anatomy and technique. This site is published by the depuy synthes companies, which are solely responsible for its content. Plate on plate osteosynthesis for the treatment of. Our elearning platform contains high resolution images and a certified cme of the open reduction and internal fixation of proximal humeral physeal fracture using synthes philos plate surgical procedure.
Shawn odriscoll, md, phd mayo foundation, ken yamaguchi, md washington university, barnes jewish hospital graham king, md, msc university of western ontario 2 table of contents table. Highly readable, accurate, and comprehensive, it clearly covers the nuts and bolts of surgical techniques in a stepbystep format that makes it easy to effectively apply basic principles to clinical practice. The purpose of this paper is to present our technique for the treatment of periplate fractures. Surgical management of proximal humerus fracture by joshi. Health, general evidencebased medicine usage fractures care and treatment fractures injuries humerus health aspects internal fixation internal fixation in fractures. The kwire should be inserted considering that the centerline of the hinge plate will be placed approximately at 6. Simple technique, easy instrumentation with color coded components. A power drill and standard jacobs chuck are required. The proximal humerus internal locking system philos youtube. You should mark the skin before any local anesthetic. Exercises for the first six weeks martin kelley, dpt of penn rehab duration. Approach the approach must normally be lengthened because of the plate. Other skin incisions will be placed adjacent to anatomic structures to hide the scar.
At the back table, assemble the plate assembly driver onto the ratcheting torque handle, and. Minimal invasive plate osteosynthesis mipo technique. Plate fixation of proximal humeral frx wheeless textbook. Philos system is an anatomical lcp plating system for proximal humerus fracture fixation. Early results in the treatment of proximal humeral fractures. Minimal invasive plate osteosynthesis mipo technique using. At the back table, assemble the plate assembly driver onto the ratcheting torque handle, and then assemble the plate to the peek spacer. The respective surgical technique, which addresses fixation failure and. The plate joystick technique to reduce proximal humeral fractures and nonunions. The majority of incisions will be placed in natural skin creases as in the upper lid skin crease for ptosis and blepharoplasty operations. Indications need sufficient bone quality always attempt in young.
Moonot et al jbjs br 2007 32 patients with 3 or 4 part treated with philos plate 31 of 32 united 2732 86% excellent or satisfatory results 532 16% poor results 1 patient avn and non union. Surgical technique synonyms, surgical technique pronunciation, surgical technique translation, english dictionary definition of surgical technique. Group 1 patients with proximal humerus fractures were treated with open reduction and internal fixation orif with philos plate. The platejoystick technique to reduce proximal humeral fractures and nonunions.
Aotk proudly launches the 20 edition of the aotk system innovations magazine, which details 15 new implants and instruments for use in trauma, spine, cmf, and veterinary surgery, and includes. It features a true anatomical reconstruction latitude total elbow prosthesis of the joint, modular components, and is adaptable to a wide range of indications. Find all the books, read about the author, and more. Suture technique and closure instrumentation the latitude surgical technique has been developed in conjunction with. Surgical management of proximal humerus fracture by joshis external stabilizing system. Surgical management of proximal humerus fracture by joshis. Treatment of proximal humerus fractures using philos plate ncbi.
In this group 12 patients had twopart fracture, 14 patients had threepart fracture and four patients had four part fracture. Evaluation of clinical and radiological outcome of. The student functions under the supervision of the instructor, staff surgical technologists, or. Please consult the surgical technique philos and philos long dsemtrm08150449 for detailed information on the implant and its indications. Proximal humerus fractures operated with philos plate.
Fixation with the philos plate is a near ideal technique with a high union rate in the treatment of proximal humeral fractures. The carefully outlined and practical explanations of anatomy and how it pertains to general surgery will help the general surgeon in avoiding complications and in developing masterful surgical technique. The aims of study were to evaluate the outcomes of our less invasive plating technique using a modified anterolateral approach in proximal humerus fracture treatment. New surgical techniques and surgical site infections. Plate fixation of proximal humeral fractures with indirect reduction. Do you want to use the redesigned ao sr like an app. Fixation of proximal humerus fractures using the philos.
Purchase handbook of surgical technique 1st edition. The art of the surgical technique plastic surgery key. Aotk system innovations 1 20 by ao foundation issuu. Concise and easy to read, it uses a highly illustrated, stepbystep approach to. Treatment of proximal humerus fractures using philos plate. Reviewed by carol scottconner, md, phd, mba university of iowa hospitals and clinics. Range longer plates cover a wider range of fractures.
In this surgical technique, the type of phlp used is the philos plate proximal humeral internal locking system. The clinical experience is received at list names of clinical rotation sites. Fixation of proximal humerus fractures using the philos plate. Now, more than ever, surgical anatomy and technique is a must have for every resident and general surgeon. Shoulder arthroplasty system tsa surgical technique. Implant assembly select the appropriate peek spacer footprint and height and the plate type zeroplate, halfplate or fullplate of the same height. The duration of the latency period is to be determined by the surgeon. Orthopedic trauma incl pediatrics your digital gateway to expertise, education, and innovation.
Plate fea tures combined with ao technique create an environment for bone healing, expediting. A novel hybrid fixation technique for osteosynthesis of isolated greater. Thoroughly revised and with dozens of new illustrations, the fourth edition continues the tradition of providing a concise, accessible, and generously illustrated memory refresher for both novice and experienced clinicians. Hessmann m, baumgaertel f, gehling h, klingelhoeffer i, goetzen l. Proper surgical procedure is the responsibility of the medical professional. With the invention of locked plating, a novel biomechan. Philos plate fixation for displaced fractures of the proximal humerus. Surgical technique definition of surgical technique by. Philos plate osteosynthesis in metaphyseal fractures of the distal. Pdf philos plate fixation for proximal humeral fractures. Textbook of operative techniques in upper extremity sports injuries.
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