scholarly journals Orthopaedic Approaches to Proximal Humeral Fractures Following Trauma

2014 ◽  
Vol 8 (1) ◽  
pp. 437-441 ◽  
Author(s):  
Reza Mafi ◽  
Wasim Khan ◽  
Pouya Mafi ◽  
Sandip Hindocha
Keyword(s):  
Healing Process ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Definitive Treatment ◽  
Process Failure ◽  
Rising Incidence ◽  
Short And Long Term ◽  
Randomised Controlled

Proximal humeral fractures have been a topic of discussion in medical literature dating back as far as 3rd century BC. Today, these fractures are the most common type of humeral fractures and account for about 5-6% of all fractures in adults with the incidence rising rapidly with age. In broad terms the management of proximal humeral fractures can be divided into two categories: conservative versus surgical intervention. The aim of treatment is to stabilize the fracture, aid better union and reduce pain during the healing process. Failure to achieve this can result in impairment of function, and significantly weaken the muscles inserting onto the proximal humerus. With the rising incidence of proximal humeral fractures, especially among the elderly, the short and long term burden for patients as well as the wider society is increasing. Furthermore, there is a lack of consistency in the definitive treatment and management of displaced fractures. This systematic review of literature compares the surgical treatment of proximal humeral fractures with their conservative management, by evaluating the available randomised controlled trials on this topic.

scholarly journals Primary Hemiarthroplasty for Proximal Humeral Fractures in the Elderly: Long-Term Functional Outcome and Social Implications

2007 ◽  
Vol 33 (5) ◽  
pp. 512-519 ◽  
Author(s):  
Michael Dietrich ◽  
Christoph Meier ◽  
Daniela Zeller ◽  
Patrick Grueninger ◽  
Roger Berbig ◽  
...  
Keyword(s):  
Functional Outcome ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Social Implications

Ten-year follow-up of stemmed hemiarthroplasty for acute proximal humeral fractures

2021 ◽  
Vol 103-B (6) ◽  
pp. 1063-1069
Author(s):  
Alexander Amundsen ◽  
Stig Brorson ◽  
Bo S. Olsen ◽  
Jeppe V. Rasmussen
Keyword(s):  
Revision Rate ◽  
Patient Reported Outcome ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patient Reported ◽  
Cumulative Revision Rate

Aims There is no consensus on the treatment of proximal humeral fractures. Hemiarthroplasty has been widely used in patients when non-surgical treatment is not possible. There is, despite extensive use, limited information about the long-term outcome. Our primary aim was to report ten-year patient-reported outcome after hemiarthroplasty for acute proximal humeral fractures. The secondary aims were to report the cumulative revision rate and risk factors for an inferior patient-reported outcome. Methods We obtained data on 1,371 hemiarthroplasties for acute proximal humeral fractures from the Danish Shoulder Arthroplasty Registry between 2006 and 2010. Of these, 549 patients (40%) were alive and available for follow-up. The Western Ontario Osteoarthritis of the Shoulder (WOOS) questionnaire was sent to all patients at nine to 14 years after primary surgery. Revision rates were calculated using the Kaplan-Meier method. Risk factors for an inferior WOOS score were analyzed using the linear regression model. Results Mean age at surgery was 67 years (24 to 90) and 445 (81%) patients were female. A complete questionnaire was returned by 364 (66%) patients at a mean follow-up of 10.6 years (8.8 to 13.8). Mean WOOS score was 64 (4.3 to 100.0). There was no correlation between WOOS scores and age, sex, arthroplasty brand, or year of surgery. The 14-year cumulative revision rate was 5.7% (confidence interval 4.1 to 7.2). Patients aged younger than 55 years and patients aged between 55 to 74 years had 5.6-times (2.0 to 9.3) and 4.3-times (1.9 to 16.7) higher risk of revision than patients aged older than 75 years, respectively. Conclusion This is the largest long-term follow-up study of acute proximal humeral fractures treated with hemiarthroplasty. We found a low revision rate and an acceptable ten-year patient-reported outcome. The patient-reported outcome should be interpreted with caution as we have no information about the patients who died or did not return a complete WOOS score. The long-term outcome and revision rate suggest that hemiarthroplasty offers a valid alternative when non-surgical treatment is not possible. Cite this article: Bone Joint J 2021;103-B(6):1063–1069.

scholarly journals Humeral Head Replacement and Reverse Shoulder Arthroplasty for the Treatment of Proximal Humerus Fracturesm

2017 ◽  
Vol 11 (1) ◽  
pp. 1108-1114 ◽  
Author(s):  
Aaron Andrew Frombach ◽  
Kendra Brett ◽  
Peter Lapner
Keyword(s):  
Shoulder Arthroplasty ◽  
New Technology ◽  
Reverse Shoulder Arthroplasty ◽  
Standard Of Care ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Current Evidence ◽  
Complication Rates ◽  
Surgical Fixation

Acute proximal humeral fractures in the elderly are generally treated non-operatively if alignment is acceptable and in stable fracture patterns. When operative treatment is indicated, surgical fixation is often difficult or impossible to obtain. Hemiarthroplasty has long been the standard of care. However, with its reliance on tuberosity healing, functional outcomes and patient satisfaction are often poor. Reverse shoulder arthroplasty has emerged as a new technology for treating proximal humeral fractures but the indications for its use remain uncertain. While not conclusive, the evidence suggests that reverse shoulder arthroplasty yields more consistent results, with improved forward elevation and higher functional outcome scores. The primary advantages of hemiarthroplasty are improved shoulder rotation and shorter operative time. Complication rates do not vary significantly between the two options. Although higher quality trials are needed to further define the role of reverse shoulder arthroplasty, current evidence suggests that this is a reasonable option for surgeons who are highly familiar with its use.

scholarly journals Poverty, old age and gender in nineteenth-century England: the case of Hertfordshire

2005 ◽  
Vol 20 (3) ◽  
pp. 351-384 ◽  
Author(s):  
NIGEL GOOSE
Keyword(s):  
Nineteenth Century ◽  
Family Support ◽  
Elderly Women ◽  
The Elderly ◽  
Elderly Male ◽  
Age And Gender ◽  
Local Sources ◽  
Short And Long Term ◽  
And Gender

This article examines the relative incidence of poverty among the elderly in nineteenth-century Hertfordshire with special reference to gender. Both national and local sources are employed to highlight the particular difficulties experienced by the elderly, male poor under the New Poor Law, and the short and long term problems they faced as a result of seasonal unemployment and an overstocked labour market. For elderly women, the extent to which their poverty was relieved by employment in cottage industry, almshouse accommodation, the continuing receipt of out-relief and a higher incidence of family support are examined to provide an assessment of the manner in which poverty was gendered in the nineteenth century.

scholarly journals The short and long term effects of exercise training in non-cystic fibrosis bronchiectasis – a randomised controlled trial

2014 ◽  
Vol 15 (1) ◽  
pp. 44 ◽  
Author(s):  
Annemarie L Lee ◽  
Catherine J Hill ◽  
Nola Cecins ◽  
Sue Jenkins ◽  
Christine F McDonald ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Randomised Controlled Trial ◽  
Exercise Training ◽  
Controlled Trial ◽  
Long Term Effects ◽  
Short And Long Term ◽  
Randomised Controlled
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