Displaced fragility fractures of proximal humerus in elderly patients affected by severe comorbidities: percutaneous fixation and conservative treatment

2013 ◽  
Vol 25 (4) ◽  
pp. 447-452 ◽  
Author(s):  
Massimo Innocenti ◽  
Christian Carulli ◽  
Roberto Civinini ◽  
Fabrizio Matassi ◽  
Massimiliano Tani ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Proximal Humerus ◽  
Fragility Fractures ◽  
Percutaneous Fixation

The Result of Conservative Treatment of Proximal Humerus Fracture in Elderly Patients

2013 ◽  
Vol 26 (4) ◽  
pp. 292
Author(s):  
Seung-Gil Baek ◽  
Chang-Wug Oh ◽  
Young-Soo Byun ◽  
Jong-Keon Oh ◽  
Joon-Woo Kim ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture

scholarly journals Indications and results of osteosynthesis for proximal humerus fragility fractures in elderly patients

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Luigi Murena ◽  
Gianluca Canton ◽  
Chiara Ratti ◽  
Bramir Hoxhaj ◽  
Gioia Giraldi ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Full Text ◽  
Elderly Population ◽  
Proximal Humerus ◽  
Surgical Techniques ◽  
Fragility Fractures ◽  
The Elderly ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Protocols ◽  
Clinical Conditions

Proximal humerus fractures (PHF) are common injuries in the elderly population. Conservative treatment is indicated for undisplaced and stable fractures, which account for almost 80% of the cases. More complex fracture patterns might need surgery, with a wide variety of indication criteria and surgical techniques described in the literature. Surgical treatment should be reserved for patients in good clinical conditions, autonomous in daily living activities and able to adhere to postoperative rehabilitation protocols. In the elderly population with severe osteoporosis, cognitive impairment and clinical comorbidities, the risk of surgical failures is high. In these patients, the choice between surgical and conservative treatment, as well as for the type of procedure, is even more difficult, with no general consensus in the literature. Final indication is usually conditioned by surgeon’s experience and preference. Two independent reviewers (B.H and G.G) independently extracted studies on proximal humeral fractures. All selected studies were screened independently (B.H and G.G) based on title and abstract. Then the full text of any article that either judged potentially eligible was acquired and reviewed again. Any disagreement was resolved by discussing the full text manuscripts. Aim of the present paper is to review the literature about indications and results of osteosynthesis for proximal humerus fragility fractures in the elderly population.

scholarly journals Mortality After Complex Displaced Proximal Humerus Fractures in Elderly Patients: Conservative Versus Operative Treatment With Reverse Total Shoulder Arthroplasty

2018 ◽  
Vol 9 ◽  
pp. 215145931879524 ◽  
Author(s):  
Dani Rotman ◽  
Ornit Giladi ◽  
Adi Berliner Senderey ◽  
Alison Dallich ◽  
Oleg Dolkart ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Elderly Patients ◽  
Shoulder Arthroplasty ◽  
Proximal Humerus ◽  
Total Shoulder Arthroplasty ◽  
Proximal Humerus Fractures ◽  
Humerus Fractures ◽  
Reverse Total Shoulder

Introduction: Proximal humerus fractures (PHFs) are a common fragility fracture and have been shown to increase mortality in elderly patients. In the last decade, reverse total shoulder arthroplasty (RTSA) was introduced as a reliable operative treatment option for this indication. In other fragility fractures, most notably hip fractures, urgent surgical treatment can reduce mortality. The purpose of this study is to evaluate whether treatment with RTSA can reduce 1-year mortality in elderly patients with complex displaced PHFs. Materials and Methods: A retrospective study was performed to compare 1-year mortality between 2 groups of elderly patients (>75 years old) who presented to a level 1 trauma center emergency department with complex displaced PHFs. The conservative treatment group (n = 83; mean age, 83.7 years) presented from 2008 to 2010 when RTSA was not yet available, and treatment was nonoperative. The surgical treatment group (n = 62; mean age, 82.2 years) presented from 2012 to 2015 and underwent RTSA. Results: One-year mortality was 8.1% (male 7.1%; female 8.3%) in the surgical treatment group and 10.8% (male 18.8%; female 9.0%) in the conservative treatment group. The reduction in mortality in the surgical treatment group was not significant (entire cohort P = .56; males P = .35; females P = .59). Discussion: Recent studies failed to show better functional results after surgical treatment with RTSA when compared to conservative treatment. This study suggests that a benefit of surgical treatment with RTSA that was not examined until now might exist—a reduction in the increased mortality risk associated with PHFs. Conclusions: There was no significant difference in 1-year mortality between the groups, although there was a trend showing lower mortality with RTSA, mostly in men. Further studies with larger populations and longer follow-up times are needed to determine whether this trend is of clinical significance.

Comparative study between operative and conservative treatment in 3 part and 4 part fracture of the proximal humerus

2000 ◽  
Vol 13 (2) ◽  
pp. 390
Author(s):  
Chang Hyuk Choi ◽  
Kwoing Woo Kwun ◽  
Shin Kun Kim ◽  
Sang Wook Lee ◽  
Dong Kyu Shin ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Comparative Study ◽  
Proximal Humerus ◽  
Operative And Conservative Treatment

scholarly journals Conservative Treatment in Intra-Articular Fractures of the Distal Radius: A Study on the Functional and Anatomic Outcome in Elderly Patients

2003 ◽  
Vol 44 (5) ◽  
pp. 836 ◽  
Author(s):  
Avni Dayican ◽  
Vuslat Sema Unal ◽  
Bulent Ozkurt ◽  
Suleyman Portakal ◽  
Ertugrul Nuhoglu ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Distal Radius ◽  
Articular Fractures

Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating

2017 ◽  
Vol 43 (2) ◽  
pp. 142-147 ◽  
Author(s):  
Daniel Martinez-Mendez ◽  
Alejandro Lizaur-Utrilla ◽  
Joaquin de-Juan-Herrero
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Distal Radius ◽  
Articular Surface ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Loss Of Reduction

We compared outcomes in elderly patients with intra-articular distal radius fractures treated by closed reduction and plaster immobilization or open reduction and internal fixation with a volar plate. Ninety-seven patients older than 60 years were randomly allocated to conservative (47 patients) or surgical (50 patients) treatment. Over a 2-year period, we assessed patient-rated wrist evaluation score, DASH (disability arm, shoulder and hand) questionnaire, pain, wrist range of motion, grip strength, and radiological parameters. The functional outcomes and quality of life were significantly better after volar plating fixation compared with conservative treatment. We found that restoration of the articular surface, radial inclination, and ulnar variance affected the outcomes, but the articular step-off did not. Twenty-five per cent of the patients with conservative treatment had secondary loss of reduction. We conclude that surgical plating leads to better outcomes than conservative treatment for elderly patients with intra-articular distal radius fractures. Level of evidence: I

Proximal humerus fragility fractures: recent trends in nonoperative and operative treatment in the Medicare population

2016 ◽  
Vol 25 (2) ◽  
pp. 256-261 ◽  
Author(s):  
Richard J. Han ◽  
David C. Sing ◽  
Brian T. Feeley ◽  
C. Benjamin Ma ◽  
Alan L. Zhang
Keyword(s):  
Operative Treatment ◽  
Proximal Humerus ◽  
Fragility Fractures ◽  
Medicare Population ◽  
Recent Trends
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