ArticleJSES international2023
Proximal humerus fracture sequelae: are corrective osteotomies still a taboo? The role of three-dimensional preoperative planning and patient-specific surgical guides for proximal humerus corrective osteotomy in combination with reverse shoulder arthroplasty.
Article in JSES international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- Corrective osteotomies of malunited proximal humerus fractures with 3D patient-specific guides: a feasibility study.JSES international · 2026Article
- Regional anesthesia strategies for proximal humerus fracture surgery: anatomical considerations, diaphragm-sparing techniques, and expert perspectives-a narrative review.Langenbeck's archives of surgery · 2026Review
- "Two-Step Shish Kebab": A Useful Technique for Reverse Shoulder Arthroplasty in Humeral Surgical Neck Non-unions.Cureus · 2026Article
- A Comprehensive Review of 3D Imaging and Printing in Proximal Humerus Fractures and Sequelae.Journal of clinical medicine · 2025Review
- [Fracture sequelae-when, how, what?]Unfallchirurgie (Heidelberg, Germany) · 2025Review
- Advances in Pediatric Orthopedic Surgery: 3D Calcium-Density Models for Humerus Deformity.The American journal of case reports · 2025Article
- Which is the optimal treatment and the most significant prognostic factor for reverse shoulder arthroplasty in case of PHAROS 2 humeral bone loss? A proportional meta-analysis of nononcologic patients.JSES international · 2025Review
- Reverse shoulder arthroplasty for two-parts proximal humerus fractures with "shish-kebab" technique.JSES reviews, reports, and techniques · 2024Article
- Computed tomography improves the diagnostic accuracy but not the interobserver reliability of the Boileau classification of proximal humerus fracture sequelae.Shoulder & elbow · 2023Article
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Abstract
Background: Symptomatic proximal humeral fracture sequelae (PHFS) represent a surgical challenge due to the altered bone and soft tissue morphology. The purpose of this study was to report the outcome of Multiplanar Corrective Humeral Osteotomies (MCHOs) in combination with reverse total shoulder arthroplasty (rTSA) performed following a three-dimensional (3D) preoperative planning and using a 3D-printed patient-specific surgical instrumentation (PSI) in type 1C, 1D, and 4 PHFS. Methods: In this prospective monocentric study, we enrolled patients affected by symptomatic PHFS type 1C, 1D, or 4 of Boileau's classification, treated between 2018 and 2019 with rTSA associated to MCHO and followed-up at 12 and 24 mo. The preoperative and postoperative Constant Score (CS), visual analog scale, and Disabilities of the Arm, Shoulder and Hand (DASH) score were recorded. All patients underwent a preoperative computed tomography, then a dedicated software was used to run a segmentation algorithm on computed tomography images. Metaphyseal bone cuts were virtually performed before surgery in all patients, and a 3D-printed PSI was used to reproduce the planned osteotomies in vivo. Results: Twenty patients completed a 2-y follow-up. The mean (± standard deviation) CS, visual analog scale, and DASH values improve from 24.3 (± 8.8), 6.5 (± 1.3), 60.7 (± 9.6) preoperatively, to 67.7 (± 11.4), 1.6 (± 0.8), 24.1 (± 13.1) points after surgery, respectively. The minimally clinical important difference for CS and DASH score was achieved in 95% of patients. No major complication was observed. One patient showed an unexplained worsening of clinical scores between the 12 and the 24-mo follow-up, while in one patient bone resorption of the greater tuberosity was observed on radiographs at 2 y, with no clinical impact. Conclusion: The combination of preoperative 3D planning and intraoperative use of 3D-printed PSI to perform MCHO as concurrent procedure in the context of rTSA in the treatment of Boileau type 1C, 1D, and 4 PHFS may lead to a satisfactory clinical outcome at 2 y of follow-up.
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