A new internal fixation technique for fractures of the proximal humerus - the Bilboquet device: A report on 26 cases

We describe a novel internal fixation device and report on 26 patients (mea n age, 70 years) whose proximal humeral fractures were managed with this te chnique. The 2-part titanium implant consists of a circular staple impacted into the humeral head cancellous bone and a spigoted diaphyseal stem that inserts into the staple "cup." OF the 26 cases reviewed, Id had 3-part frac tures and 10 had 4-part fractures. Mean Follow-up was 25.9 months. In the 1 6 3-part fractures, the mean active forward elevation was 114 degrees and t he results were as follows: excellent, 7; good, 5; fair, 3; poor, 7. In the 70 4-part fracture patients, the mean active forward elevation was 101 deg rees and the results were as Follows: excellent, 2; good, 4; fair 3;poor, I . There were 5 cases OF avascular necrosis and I case of tuberosity nonunio n. Only 2 cases needed conversion to hemiarthroplasty. The new technique sh ould simplify the surgery of these fractures and reduce the need for arthro plasty.