EVALUATION OF SURGICAL TREATMENT OF FRACTURES IN TWO OR THREE PARTS OF THE PROXIMAL HUMERUS WITH THE “PARACHUTE TECHNIQUE”

ABSTRACTObjective: To evaluate the efficacy and safety of the surgical technique called the “parachute technique, as applied to adult patients who suffered displaced and unstable two or three-part fractures of the proximal humerus, through the clinical outcomes. Methods: Between January 1995 and June 2006, 59 adult patients with displaced and unstable two or three-part fractures underwent operations performed by the Shoulder and Elbow Group of the Orthopedics and Traumatology Service of Hospital do Servidor Público Estadual de São Paulo using the “parachute technique. This method consists of an intramedullary tension band and extramedullary fixation in a figure-of-eight to join the fragments of the fracture, using a 6.5-millimeter spongy screw with partial threading, a washer and two non-absorbable wires, thereby producing stable synthesis with minimal aggression to the surrounding soft tissue and not requiring any subsequent removal of material. The final shape of this synthesis is reminiscent of the shape of an open parachute. The patients had a minimum postoperative follow-up of six months. For the diagnosis, trauma series radiographic views of the shoulder were produced. The fractures were classified in accordance with the system proposed by Neer. We used the scale of the University of California, Los Angeles (UCLA), to evaluate the results. Results: The “parachute technique” produced good results in 47% and excellent results in 26% of the cases, according to the UCLA scores. Conclusion: The “parachute technique” is a safe and effective treatment for displaced and unstable two or three-part fractures of the proximal humerus.