Proximal Humerus Fractures

2018 ◽  
pp. 71-94
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
Internal Fixation ◽  
Proximal Humerus ◽  
Nonoperative Treatment ◽  
Proximal Humerus Fractures ◽  
Imaging Studies ◽  
Residual Pain ◽  
Functional Loss ◽  
Orthopedic Surgeon ◽  
Technical Complications ◽  
Humerus Fractures

Fractures of the proximal humerus are common. A relatively large number of these injuries will heal with nonoperative treatment without major residual pain or functional loss. However, internal fixation or arthroplasty leads to a much better outcome for selected fractures. The orthopedic surgeon dealing with these injuries is faced with three challenges. First, it is difficult to understand these fractures based on imaging studies and to select those patents that will do better with surgery. Second, internal fixation and arthroplasty for proximal humerus fractures are difficult procedures and fraught with technical complications. And third, complications often require challenging salvage procedures.

Internal fixation of proximal humerus fractures using the T2-proximal humeral nail

2008 ◽  
Vol 129 (9) ◽  
pp. 1239-1244 ◽  
Author(s):  
Dragos Popescu ◽  
Jenaro A. Fernandez-Valencia ◽  
Moisés Rios ◽  
Jordi Cuñé ◽  
Anna Domingo ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Humerus Fractures

scholarly journals FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING COMPRESSION PLATE: A CROSS SECTIONAL STUDY

2021 ◽  
Vol 10 (4) ◽  
pp. 3266-3269
Author(s):  
Abhishek Patil
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Humerus Fractures ◽  
The Mean

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.

scholarly journals A Comparative Study of Open Reduction and Internal Fixation with PHILOS Plate versus Closed Reduction and Fixation with Percutaneous K Wiring of Neer’s 2-Part and 3-Part Proximal Humerus Fractures

2020 ◽  
Vol 7 (40) ◽  
pp. 2247-2250
Author(s):  
Mahesh Gangaiah ◽  
Monesh Kanakappa Basavaraj ◽  
Balaraj Gowda Hanumantappa ◽  
Girish Halasinanagenahalli Rudrappa ◽  
Balakrishnan Honnapura Doppapettigama ◽  
...  
Keyword(s):  
Comparative Study ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Plate Versus ◽  
Proximal Humerus Fractures ◽  
Philos Plate ◽  
Humerus Fractures

Is serial radiological evaluation of one-part proximal humeral fractures necessary?

2019 ◽  
Vol 101-B (10) ◽  
pp. 1307-1312
Author(s):  
Matthijs Jacxsens ◽  
Jeremias Schmid ◽  
Vilijam Zdravkovic ◽  
Bernhard Jost ◽  
Christian Spross
Keyword(s):  
Bone Quality ◽  
Proximal Humerus ◽  
Constant Score ◽  
Nonoperative Treatment ◽  
Proximal Humerus Fractures ◽  
Radiological Evaluation ◽  
Fracture Configuration ◽  
Secondary Displacement ◽  
Humerus Fractures

Aims In order to determine whether and for whom serial radiological evaluation is necessary in one-part proximal humerus fractures, we set out to describe the clinical history and predictors of secondary displacement in patients sustaining these injuries. Patients and Methods Between January 2014 and April 2016, all patients with an isolated, nonoperatively treated one-part proximal humerus fracture were prospectively followed up. Clinical and radiological evaluation took place at less than two, six, 12, and 52 weeks. Fracture configuration, bone quality, and comminution were determined on the initial radiographs. Fracture healing, secondary displacement, and treatment changes were recorded during follow-up. Results In 100 patients (59 female, 41 male; mean age 57 years), 91 of the fractures (91%) remained stable. In five of nine patients (55%) with secondary displacement, surgery was recommended. Comminution, present in 23 patients (23%), was identified as a predictor of secondary displacement (p < 0.001). Patients’ age, sex, fracture configuration, and bone quality were not associated with secondary displacement (p ≥ 0.438). Nonoperative treatment resulted in a mean absolute Constant score (CS) of 80 (49 to 98), relative CS of 101% (63% to 138%), median subjective shoulder value of 95% (interquartile range (IQR) 90% to 100%), and median EuroQol five-dimensional questionnaire score of 0.89 (IQR 0.80 to 1.00) with bone union in all cases at one-year follow-up. Conclusion Radiological re-evaluation was only necessary in patients presenting with comminution and may be redundant for 77% of patients with one-part proximal humerus fractures. Nonoperative treatment of one-part proximal humerus fractures remains the mainstay of treatment with a low rate of secondary surgery, a high union rate, and good clinical results. Cite this article: Bone Joint J 2019;101-B:1307–1312

Sign in / Sign up

Export Citation Format

Share Document