H Godry

Publications (3)2.59 Total impact

• Article: Primäre Schulterendoprothetik nach Trauma

  D. Seybold, M. Königshausen, H. Godry, G. Muhr, C. Gekle
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  ABSTRACT: Die primäre Frakturendoprothetik der Schulter ist in den letzten Jahren aufgrund der verbesserten Osteosyntheseverfahren mit kleinfragmentären, winkelstabilen Plattensystemen eher rückläufig. Die Schwierigkeit bei der 4-Fragment-Fraktur bei erhaltener Kopfkalotte liegt in der Reposition und Retention der Tuberkel in anatomischer Position. Diese Problematik wird durch die Frakturprothetik nicht gelöst. Bei kompletten Head-Split-Frakturen ist der Ersatz der Kalotte durch eine Prothese indiziert. Das Problem der stabilen Tuberkelrefixation und knöchernen Integration bleibt jedoch bestehen. Neue Prothesendesigns verbessern die Tuberkelrefixationsmöglichkeit und die korrekte Positionierung der Prothese. Eine anatomische Frakturrekonstruktion ist immer primäres Ziel und sollte nicht zu früh verlassen werden. Indications for primary shoulder prosthesis in displaced four-part fractures has decreased in recent years due to new techniques in fracture reconstruction using angle-stable plate osteosynthesis. The challenge of four-part fractures with an intact head fragment is the anatomic reconstruction and fixation of the tuberosities. Using a fracture prosthesis does not solve this problem. In complex head-split fractures arthroplasty is indicated, but the difficulty of tuberosity refixation and healing remains. New prosthetic designs improve tuberosity fixation and healing, as well as correct placement and orientation of the prosthesis. Anatomic fracture reconstruction should always be the goal and this goal should not be abandoned too easily. SchlüsselwörterSchulterprothese-Humeruskopffraktur-Winkelstabile Plattenosteosynthese-Tuberkelrefixation-Anatomische Frakturrekonstruktion KeywordsShoulder arthroplasty-Proximal humeral head fractures-Angle stable osteosynthesis-Tuberosity refixation-Anatomic fracture reconstruction
  Trauma und Berufskrankheit 04/2012; 12(1):6-11.
• Article: Clinical outcome and complications using a polyaxial locking plate in the treatment of displaced proximal humerus fractures. A reliable system?

  M Königshausen, L Kübler, H Godry, M Citak, T A Schildhauer, D Seybold
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  ABSTRACT: The surgical treatment of displaced proximal humeral fractures (ORIF) is a perpetual challenge to the surgeon. For this reason, the principle of polyaxiality was developed to provide an improved primary stability of the fracture through better anchorage of the screws, especially in osteoporotic bone. The aim of this study was to present clinical results with the polyaxial locking plate in the operative treatment of proximal humerus fractures in order to determine whether the technique of polyaxiality leads to better functional outcome and lower complication rates in comparison to monoaxial plates in the literature. Seventy-three patients with displaced proximal humeral fractures were treated surgically with the polyaxial locking Suture Plate™ (Arthrex(®)) between 03/2007 and 06/2009. Fifty-two of the patients (mean age, 69.9 ± 12.1) were included in a radiographical and clinical examination using the Constant score (CS) and the Disabilities of the Arm, Shoulder and Hand score (DASH). The follow-up examinations were on average 13.9 ± 4.5 months (10-27 months) after surgical treatment. The mean CS of the patients was 66.0 ± 13.7 points, the age- and gender-related CS was 90.9% ± 20.0% and the mean DASH score was 23.8 ± 19.8 points for the injured side. The patients with a nearly anatomical reduction of their fracture (n = 13) reached a significantly higher CS (75.1 ± 8.5; p = 0.004) and DASH-score (13.6 ± 11.6; p = 0.043) and none of these patients had a complication. The complications were identified in 12 (23.1%) cases, 5 of which involved loss of reduction. All of these 5 cases were lacking of initial medial column support and 4 of which were type C2.3 AO-Classification. The data show that the combination of angular stability with the possibility of variable polyaxial screw direction is a good concept for reduction and fixation of displaced proximal humeral fractures, but anatomical reduction and medial support remain important preconditions for a good outcome. However, a significantly lower rate of complications or better clinical outcome than that reported in the literature could not be found.
  Injury 02/2012; 43(2):223-31. · 1.98 Impact Factor
• Article: [A new reduction technique for posterior locked shoulder dislocation. Case report and technique description].

  H Godry, M Citak, M Königshausen, T A Schildhauer, D Seybold
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  ABSTRACT: The case of a 61-year-old male with posterior dislocation of the right shoulder joint is presented and a new technique for closed reduction of posterior locked shoulder dislocation is described. The technique involves four steps: in step 1 a constant traction is applied on the injured arm, in step 2 the arm is internally rotated and in steps 3 and 4 the second arm of the physician is used as a lever arm to lateralize and ventralize the shoulder. Lateralization and ventralization of the humeral head are essential to engage the humeral head and to pass it around the glenoid during reduction. Steps 3 and 4 are performed simultaneously. In the presented case the patient suffered a traumatic shoulder dislocation with a rim fracture of the glenoid. After reduction the shoulder was stable and conservative treatment was performed. A 2 year follow-up examination revealed a pain-free and stable shoulder with free range of motion and an Oxford instability score of 48 points. The described reduction technique for posterior locked shoulder dislocation is a simple and gentle technique, which can be performed easily by one person.Presentation of a reduction technique for locked posterior shoulder dislocation. Constant traction and internal rotation is performed for engaging the locked humeral head. After disengaging the humeral head the reduction is performed by using the arm of the physician as a lever arm.
  Der Unfallchirurg 12/2011; 115(8):754-8. · 0.61 Impact Factor