scholarly journals Fracture Dislocation of Shoulder

2014 ◽  
Vol 3 (2) ◽  
pp. 44-45
Author(s):  
Hemanta Kumar Manandhar ◽  
Pramod Devkota ◽  
Padam Bahadur Khadka ◽  
Chakra Raj Randey
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Shoulder Dislocation ◽  
Open Reduction ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Good Range

Simultaneous dislocation of shoulder with fracture of the ipsilateral humerus is extremely rare and very little reported in the literature. We report a case of forty three year old man who got right shoulder dislocation with proximal humerus fracture. The patient was treated with open reduction and internal fixation by three 4.5mm screws. The operation went uneventful and has good range of motion of the shoulder after six months of follow up. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9529   NOAJ July-December 2013, Vol 3, Issue 2, 44-45

scholarly journals SEVER INFERIOR HUMERAL HEAD SUBLUXATION FOR 3 MONTHS IN PROXIMAL HUMERUS FRACTURE DISLOCATION

2021 ◽  
Vol 9 (08) ◽  
pp. 870-873
Author(s):  
Emad M. Allehyani ◽  
Ahmed K. Alsarhani ◽  
Ahmed Alsyed
Keyword(s):  
Humeral Head ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Axillary Nerve ◽  
Fracture Pattern ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Medical Illness ◽  
Patient Factors

Proximal humerus fracture is common fracture 4-6% of all fractures (1), third most common non vertebral fracture in elderly >65 years (2), affecting female more than males in ratios of 2:1.Approximately half (51%) of these fractures are displaced, the majority of which involve the surgical neck (77%). (3) Surgical treatment (mainly internal fixation or humeral head replacement) is being increasingly used (4).Management of each fracture is dependent of patient factors, fracture pattern, and complexity.Case scenario:33 years old female not known to has any medical illness, presented to the emergency department with right shoulder pain and inability to move it after motor cycle accident. X-rayshowed proximal humerusfracture dislocation Upon Post-operative follow up patient developed sever inferior humeral head subluxation, With intact axillary nerve sensation and motor exam.Discussion:proximal humerus fracture is common, fracture pattern and type, with patient factors will guide your management.proximal humerus fracture dislocation is more difficult and challenging to surgeon in managing such fracture, with inferior hemeral head subluxation is common can reach to 42% in the radiographic incidence among proximal humerus fracture.

scholarly journals Outcomes of Proximal Humerus Fracture Open Reduction Internal Fixation with Concomitant Ipsilateral Shoulder Girdle Injuries: a Case Control Study

2016 ◽  
Vol 12 (2) ◽  
pp. 105-110
Author(s):  
Marschall B. Berkes ◽  
Milton T. M. Little ◽  
Nadine C. Pardee ◽  
Patrick C. Schottel ◽  
Lionel E. Lazaro ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humerus Fracture ◽  
Case Control Study ◽  
Proximal Humerus ◽  
Shoulder Girdle ◽  
Case Control ◽  
Open Reduction Internal Fixation ◽  
Humerus Fracture ◽  
Control Study

scholarly journals Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years

2012 ◽  
Vol 15 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Ki Won Lee ◽  
Young Joon Choi ◽  
Hyung Sun Ahn ◽  
Chung Hwan Kim ◽  
Jae Kwang Hwang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Humerus Fracture ◽  
Vas Score ◽  
Compression Plate ◽  
The Mean

PURPOSE: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated.MATERIALS AND METHODS: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle.RESULTS: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head.CONCLUSION: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

scholarly journals Selective Glenohumeral external rotation deficit – sequelae of post-ORIF deltoid adhesions after treatment of the proximal humerus fracture

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Jarosław Fabiś
Keyword(s):  
Range Of Motion ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
External Rotation ◽  
Shoulder Function ◽  
Humerus Fracture ◽  
Plate Removal ◽  
Special Regard ◽  
Constant Murley Score

Abstract Background The deltopectoral approach is commonly used for plate stabilization of proximal humerus fracture. Although adhesions between the deltoid, plate, and humerus are common sequelae of plate ORIF, little is known about their effect on the range of movement and a function of the shoulder. To confirm their impact, the preoperative and intraoperative evaluation of the range of motion (ROM) was measured during the sequential arthroscopic release of adhesions, with special regard to external rotation. Postoperative ROM and subjective shoulder function were also evaluated. Methods Eighteen patients treated with ORIF of the proximal humerus were scheduled to the unified arthroscopic procedures comprising sequential limited subacromial bursectomy, removal of the adhesions between the deltoid, plate, and humerus, as well as the plate removal. The ROM of the operated and opposite shoulders were assessed before surgery, intraoperatively and after a minimum two-year follow-up, with special regard to external rotation in adduction (AddER) and abduction (AbdER). Besides, the Constant-Murley score and Subjective Shoulder Value (SSV) were evaluated before a plate removal and after a minimum two-year follow-up after the surgery. Results Deltoid adhesion release correlated with considerable and statistically significant improvement of AddER (p < 0.0002) but not with the intraoperative range of AbdER. Significant improvement of AddER, but also of AbdER and other range of motion was noted at the follow-up. The improvement of the affected shoulder function following arthroscopic plate removal was considerable and statistically significant according to the modified Constant-Murley score (p < 0,01) and SSV (p < 0.0000) after a minimum of two-year follow-up. Conclusions Our findings are the first to highlight the influence of deltoid muscle, plate, and humerus adhesions on limiting external rotation in adduction after ORIF treatment of proximal humerus fractures. These observations allow the identification of a new shoulder evaluation symptom: Selective Glenohumeral External Rotation Deficit (SGERD) as well as functional deltohumeral space.

scholarly journals Cost-effectiveness of Open Reduction and Internal Fixation Compared With Hemiarthroplasty in the Management of Complex Proximal Humerus Fractures

2018 ◽  
Vol 2 ◽  
pp. 247154921775145
Author(s):  
Robert J Thorsness ◽  
James C Iannuzzi ◽  
Edward J Shields ◽  
Katia Noyes ◽  
Ilya Voloshin
Keyword(s):  
Cost Effectiveness ◽  
Internal Fixation ◽  
Open Reduction ◽  
Retrospective Cohort ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Cost Effective ◽  
Humerus Fracture ◽  
Proximal Humerus Fractures ◽  
Humerus Fractures

Objectives To determine if open reduction and internal fixation (ORIF) is more cost-effective than hemiarthroplasty (HA) in the management of proximal humerus fracture. Design Retrospective cohort study with cost-effectiveness analysis. Setting Tertiary referral center in Rochester, NY. Patients/participants The records of 459 consecutive patients in whom a proximal humerus fracture was treated surgically at our institution between the years 2002 and 2012 were studied retrospectively. We identified 30 consecutive patients with a mean follow-up of 60.3 months (13.6–134.5 months) of which 15 patients underwent primary ORIF and another 15 underwent primary HA for the management of head-splitting fracture or fracture-dislocation of the proximal humerus. Intervention HA or ORIF for the management of proximal humerus fracture. Main outcome measurements SF-36 scores were converted to utility weights, and a cost-effectiveness model was designed to evaluated ORIF and HA. Results Given the baseline assumptions, ORIF was slightly more costly but also more effective (0.75 quality-adjusted life years [QALY] vs 0.67 QALY) than HA. The incremental cost-effectiveness ratio (ICER) was $5319/QALY for ORIF compared to HA, which is less than the cost-effectiveness standard utilized based on a willingness to pay of $50,000/QALY. Conclusions Compared to HA, ORIF is the more cost-effective approach for the surgical management of complex proximal humerus fractures. These data are limited by patient selection which would impact the relative utility scores. These results suggest that ORIF should be considered the preferable surgical approach given payer and patient perspectives. Level of Evidence: This is a Level III retrospective, cohort therapeutic study.

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