scholarly journals Surgical treatment outcomes of proximal humerus fractures including shoulder hemiarthroplasty in patients of the Orthopedics and Trauma Department in Siedlce

2019 ◽  
Vol 84 (4) ◽  
pp. 101-106
Author(s):  
Marek Marczuk ◽  
◽  
Maciej Płończak
Keyword(s):  
Surgical Treatment ◽  
Treatment Outcomes ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Shoulder Hemiarthroplasty ◽  
Humerus Fractures

scholarly journals Analysis of predictors of mortality after surgical and non-surgical management in proximal humerus fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alejandro Garcia-Reza ◽  
Diego Matias Dominguez-Prado ◽  
Constantino Iglesias-Nuñez ◽  
Lucia Alvarez-Alvarez ◽  
Beatriz Hernandez-Gonzalez ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Proximal Humerus ◽  
Cox Regression ◽  
Survival Rates ◽  
Osteoporotic Fractures ◽  
Fundamental Parameter ◽  
Proximal Humerus Fractures ◽  
Level Of Evidence ◽  
Humerus Fractures

Abstract Background Proximal humerus fractures are one of the main osteoporotic fractures. Choosing between conservative or surgical treatment is a controversial topic in the literature, as is the functional impact. The main aim of our study was to analyse whether patient comorbidities should influence the final therapeutic decision for these fractures. Material and methods We collected data from 638 patients with proximal humerus fractures. The main variable collected was exitus. We also collected the following data: age, gender, type of fracture, laterality, type of treatment, production mechanism, comorbidities and the Charlson comorbidity index (CCI) for each patient. The therapeutic indication used the criteria established by the Upper Limb Unit in our centre. We performed chi-square tests, Fischer’s exact tests and Student’s t-tests to compare the variables. We used the Kaplan–Meier method to analyse both the overall and disease-specific survival rates. We employed the Cox regression model to analyse factors associated with mortality. Results Patients with a CCI greater than 5 showed greater mortality (HR  = 3.83; p  < 0.001) than those with a CCI lower than 5. Within the patients who underwent surgery, those with a CCI higher than 5 had an increased mortality rate (HR  = 22.6; p < 0.001) compared with those with a CCI lower than 5. Within the patients who received conservative treatment, those with a CCI over 5 showed greater mortality (HR  = 3.64; p  < 0.001) than those with a CCI under 5. Conclusions Patients with proximal humerus fractures and associated comorbidities (CCI > 5) presented higher mortality than healthier patients. This mortality risk was greater in patients with comorbidities if surgical treatment was indicated rather than conservative treatment. Patient’s comorbidities should be a fundamental parameter when planning the therapeutic strategy. Level of evidence Level 3.

Surgical treatment of displaced proximal humerus fractures with a short intramedullary nail

2011 ◽  
Vol 20 (8) ◽  
pp. 1241-1247 ◽  
Author(s):  
Betsy M. Nolan ◽  
Matthew A. Kippe ◽  
J. Michael Wiater ◽  
Gregory P. Nowinski
Keyword(s):  
Surgical Treatment ◽  
Intramedullary Nail ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Humerus Fractures

scholarly journals Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012

2018 ◽  
Vol 12 (2) ◽  
pp. 111-116 ◽  
Author(s):  
A. I. Cruz Jr ◽  
J. E. Kleiner ◽  
J. A. Gil ◽  
A. D. Goodman ◽  
A. H. Daniels ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Operative Treatment ◽  
Proximal Humerus ◽  
National Database ◽  
Proximal Humerus Fractures ◽  
Children's Hospital ◽  
Severity Scores ◽  
Children’S Hospital ◽  
Humerus Fractures ◽  
Over Time

Purpose To estimate the rate of surgical treatment of paediatric proximal humerus fractures over time utilizing a large, publicly available national database. Methods The Healthcare Cost and Utilization Project Kids’ Inpatient Database was evaluated between the years 2000 and 2012. Proximal humerus fractures were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) diagnosis codes. ICD-9 CM procedure codes were used to identify patients who received surgical treatment. Univariable and multivariable logistic regression were used to determine variables associated with greater proportions of surgical treatment. All statistical analyses were performed utilizing SAS statistical software v.9.4. Statistical significance was set at p < 0.05. Results A total of 7520 proximal humerus fracture admissions were identified; 3247 (43.2%) were treated surgically. The percentage of patients receiving surgery increased from 39.3% in 2000 to 46.4% in 2012 (p < 0.001). After adjustment for potential confounders, increased age, increased ICD-9 derived injury severity scores (ICISS) and more recent year were associated with an increased proportion of patients receiving surgical treatment (p < 0.001). Medicaid payer status (p < 0.001) and admission to a children’s hospital (p = 0.045) were associated with a lower proportion of surgical treatment. Conclusion The rate of operative treatment of paediatric proximal humerus fractures increased over time between 2000 and 2012. Increased surgical rates were independently associated with older age, increased ICISS, treatment at a non-children’s hospital and non-Medicaid insurance status. Further study is needed to provide evidence to support improved outcomes after operative treatment of paediatric proximal humerus fractures. Level of Evidence IV

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