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Proximal humeral fracture

Giandomenico Logroscino, Fabrizio Donati, Michela Saracco, Luciano Pilloni, Corrado Piconi
Angular stability locking plates are commonly used in proximal humeral fractures, especially in old patients with osteoporotic bones. These implants show good results in short and midterm follow-up, but complications are not uncommon. Here we present a case report to describe a case of early failure of a proximal angular stability plate implanted in a 72 years old female with a highly unstable two part proximal humeral fracture. An optical and metallurgic analysis was also conducted to study the modalities of failure...
October 2018: Trauma Case Reports
M Ceynowa, M Treder, F Dąbrowski, M Piotrowski, R Pankowski, M Rocławski
We present a case of a post-surgical complete dislocation after excessive proximal humeral shortening osteotomy performed in a patient operated on for atrophic non-union of a proximal humeral fracture. This complication has not been previously reported. The dislocation occurred due to extensive laxity of the soft tissue envelope, predominantly the deltoid muscle, as well as rotator cuff tear. The reconstructive procedurę consisted of vertical duplication of the capsule, reinforcement of the repair with coracoacromial ligament, tenodesis of the long head of the biceps tendon to the conjoined tendon and distal transfer of the deltoid muscle...
October 2018: Trauma Case Reports
Guan-Ming Kuang, Tak Man Wong, Jun Wu, Jun Ouyang, Haihua Guo, Yapeng Zhou, Christian Fang, Frankie K L Leung, William Lu
Introduction: The purpose of this study was to test whether local filling of a novel strontium-containing hydroxyapatite (Sr-HA) bone cement can augment the fixation of a locking plate system in a cadaveric proximal humeral facture model. Materials and Methods: Twelve pairs of formalin-treated cadaveric humeri were used. One side in each pair was for cemented group, while the other side was for the control group. The bone mineral density (BMD) of the samples was tested...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
F Reuther, M Petermann, R Stangl
OBJECTIVE: The study aimed to evaluate the clinical outcomes of reverse shoulder arthroplasty (RSA) in elderly patients with proximal humeral fractures and assess the role of tuberosity healing on the outcome. DESIGN: Case series SETTING:: Multicentre clinical study of level-2 trauma centres PATIENTS/PARTICIPANTS:: We included 81 patients with a mean age of 78.5 ± 6.5 years (range, 58.5-90.9 years) and a non-reconstructable proximal humeral fracture. INTERVENTION: Modular reverse fracture shoulder arthroplasty...
September 10, 2018: Journal of Orthopaedic Trauma
Ming Li, Yanhua Wang, Yupeng Zhang, Ming Yang, Peixun Zhang, Baoguo Jiang
Objective The optimal surgical intervention on the treatment for proximal humeral fractures (PHFs) remains uncertain. The aim of this study was to evaluate clinical outcomes following fixation of PHFs by intramedullary nails or locking plates Methods The Cochrane Library, PubMed, EMBASE, China Knowledge Resource Integrated (CNKI), Chongqing VIP and Wanfang databases were systematically searched for studies published between January 01, 1996 and December 31, 2016 that investigated intramedullary nail vs. locking plate in the surgical treatment of PHFs...
October 1, 2018: Journal of International Medical Research
Jia-Cheng Zang, Jing-Jing Du, Chen Li, Jing-Bo Wang, Xin-Long Ma
AIM: We conducted this meta-analysis for comparing the efficacy and safety in proximal humeral fractures by treatment minimally invasive plate osteosynthesis and open plating. METHODS: The potential academic literature were identified from the Cochrane Library, Springer, PubMed, Embase and ScienceDirect. Pooled data were analyzed by RevMan 5.1. RESULTS: Seven studies marched with the inclusion criteria. Meta-analysis showed the significant differences in terms of blood loss, operative time, length of hospital stays and constant score between two groups...
October 1, 2018: Journal of Comparative Effectiveness Research
Carlos García-Fernández, Yaiza Lopiz, Belén Rizo, Laura Serrano-Mateo, Borja Alcobía-Díaz, Alberto Rodríguez-González, Fernando Marco
BACKGROUND: This study evaluates the clinical outcomes in patients with proximal humerus fractures (PHF) treated with reverse total shoulder arthroplasty (RTSA) as a revision procedure for failed fixation that have more than 5 years of follow-up. MATERIALS AND METHODS: This is a retrospective study of 270 RTSA. The inclusion criteria for this study consisted of patients initially treated with either open reduction and plate fixation (ORIF) or fixation using an intramedullary nail (IMN), who were managed with a single-stage revision to a RTSA, and had a minimum of 24 months clinical and radiological follow-up...
September 2018: Injury
Carlos Torrens, Raquel Marí, Marta Cuenca, Tulia Ferrer, Klaus Langohr, Fernando Santana
The objective of this study is to analyze the effect of different imaging modalities in treatment decision making in proximal humeral fractures. After evaluation of 116 consecutive proximal humeral fractures, observers were asked to give treatment recommendation (conservative vs. surgery). If surgery was proposed, they were told to select surgery of choice. When 3D imaging was added, complexity of fractures significantly increased (p < 0.001), number of surgeries significantly increased (p < 0...
December 2018: Journal of Orthopaedics
N Hawi, E Liodakis, S Razaeian, R Meller, C Krettek
The PROFHER study is a multicenter randomized controlled trial of 250 out of 1250 patients assessed for eligibility with dislocated proximal humeral fractures with involvement of the surgical neck. These patients were randomized either for surgery or conservative treatment. Patients with comorbidities that precluded surgery, lack of mental capacity, luxation fractures or clear indications for surgery from the authors' perspective were excluded. To evaluate the outcome, standardized self-assessment methods were used (patient reported outcome [PRO]), including the Oxford shoulder score (OSS)...
October 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Qiuke Wang, Yifei Liu, Ming Zhang, Yu Zhu, Lei Wang, Yunfeng Chen
BACKGROUND: To identify the optimal viewing angles for every proximal screw in PHILOS plate-fixed proximal humeral fractures. METHODS: Three fresh-frozen human cadaveric bodies with six intact shoulders were studied. All three bodies were put in the beach chair position and PHILOS plates were placed on the proximal humerus. Head screws penetrating 1 mm into the joint were fitted one by one. Fluoroscopy was conducted in the 180° horizontal plane and the 120° coronal plane to analyze each screw's penetration in every shoulder...
September 7, 2018: BMC Musculoskeletal Disorders
L G Domínguez-Gasca, F Chico-Carpizo, J Magaña-Reyes, L G Domínguez-Carrillo
INTRODUCTION: Disabling shoulder problems in the elderly are common. OBJECTIVE: To quantify the diagnoses found in 100 consecutive shoulders cases in rehabilitation and its functional impact on the DASH scale. MATERIAL AND METHODS: 100 consecutive patients with age 65 years received in the Rehabilitation Department, performing diagnosis and functional assessment in the DASH scale. RESULTS: Distribution by gender with predominance of the female (67%); the age showed variation from 65 to 98 years with average and SD 78 ± 12...
January 2018: Acta Ortopédica Mexicana
Eric D Wicks, Alex E White, Sh'Rae Marshall, Christopher J Hadley, Christopher C Dodson
BACKGROUND: Humerus fractures caused by the throwing motion are extremely rare. They have been reported mostly in recreational adult athletes in their third or later decades of life. A pediatric thrower's fracture is even less common, with few reported cases. The pediatric version of this fracture is located in the proximal to midshaft humerus, distinguishing it from the adult type, which occurs in the middle to distal shaft. CASE REPORT: A 12-year-old male pitcher experienced a "snap" in his right arm while throwing a pitch in a baseball game...
October 2018: Journal of Emergency Medicine
Romain Colombi, Thomas Chauvet, Ludovic Labattut, Brice Viard, Emmanuel Baulot, Pierre Martz
PURPOSE: The gold standard for intramedullary nailing (IMN) in humeral shaft fracture treatment is bipolar interlocking. The aim of this study was to compare clinical and radiographic outcomes in two cohorts of patients treated with IMN with or without distal interlocking. We hypothesized that there was no significant difference between isolated proximal interlocking and bipolar interlocking in terms of consolidation and clinical results. METHODS: One hundred twenty-one acute humeral shaft fractures were retrospectively included in group WDI (without distal interlocking screw, n = 74) or in group DI (with distal interlocking screw, n = 47)...
August 31, 2018: International Orthopaedics
Christopher Lindsay, Eddie Hasty, Daniel Carpenter, Paul Weinhold, Robert F Ostrum
The most common operative treatment of proximal humerus fractures is internal fixation with fixed-angle locking plates. Although this surgical technique has been refined, a significant failure rate remains. This study aimed to determine whether the number of locking screws in the humeral head affects the biomechanical strength and stability of the construct in bone from elderly individuals. Ten pairs of embalmed cadaveric humeri were osteotomized in a gap model and fixed with periarticular locking plates placed in the standard position...
September 1, 2018: Orthopedics
Nawaf Sulaiman Alogayyel, Mohamed Dhafer Aldawodi, Bandar Ahmed, Ayman H Jawadi
Introduction: Shoulder dislocation is the most common type of all joints dislocations. It occurs when there is separation in the glenohumeral joint. Posterior dislocation accounts for less than 4% of all shoulder dislocations. In fact, it is misdiagnosed in 60-79% of the patients in the initial presentation. In children a posterior shoulder dislocation is usually caused by a congenital anomaly or in those who have ligamentous laxity. Traumatic posterior shoulder dislocation without fracture of the proximal humeral epiphysis in children is very rare, and only few cases have been reported...
September 2018: Annals of Medicine and Surgery
Matías J Esteras-Serrano, Isabel M Ruiz-Hernández, Josep O Gimferrer-Arriaga, Marcos Sánchez-Jimenez, Aina Far-Riera, J M Rapariz
Introduction: Preoperative comorbidity seems to be an important factor for the functional recovery of patients after shoulder replacement, but few studies support this correlation.The purpose of this study was to clinically evaluate the influence of comorbidity in restoring function after shoulder replacement. Methods: We performed a retrospective analysis of shoulder replacement accomplished at our institution from 2005 to 2016 (n = 70). Demographic data, number of comorbidities, preoperative drugs, type of arthroplasty, and postoperative complications were collected...
September 2018: Journal of Orthopaedics
Jacob J Triplet, Harris Gellman, David Clause, Nicholas M Halikis
BACKGROUND: Fractures of the hook of the hamate are rare. Nonoperative management has historically been immobilization in a short arm cast (SAC) without thumb immobilization with a high reported incidence of nonunion. The high prevalence of nonunion following nonoperative treatment may be secondary to motion at the fracture site. The transverse carpal ligament's attachment to the hook of the hamate results in movement at the fracture site during thumb motion. METHODS: A cadaveric study using 8 fresh frozen cadaver arms amputated at the mid-humeral level was performed...
August 18, 2018: Hand: Official Journal of the American Association for Hand Surgery
Qiuke Wang, Jian Hu, Junjie Guan, Yunfeng Chen, Lei Wang
BACKGROUND: To explore the clinical efficacy of 3D printing fracture models to assist in creating pre-contoured plates to treat proximal third humeral shaft fractures. METHODS: We retrospectively identified proximal third humeral shaft fractures treated between February 2012 and February 2015. The patients were divided into two groups according to the treatment procedure: a Synbone group and a 3D-printed group. In the Synbone group, long proximal humeral internal locking system plates were pre-contoured into helical shape on Synbones before surgery, while in the 3D-printed group, they were contoured on 3D-printed bone models...
August 17, 2018: Journal of Orthopaedic Surgery and Research
Kevin Tetsworth, Erik Hohmann, Vaida Glatt
Most closed humeral shaft fractures can be successfully managed nonsurgically. However, fractures for which closed treatment is unsuccessful are stabilized using either plates or intramedullary nails. There are shortcomings associated with each technique, including the potential complications of nonunion, infection, shoulder pain, and radial nerve injury. Minimally invasive plate osteosynthesis (MIPO), an innovative alternative treatment, is gaining in popularity. This technique is based on the anterior humeral shaft providing a relatively safe surface for plate application, and limited open exposures proximally and distally allow percutaneous insertion of the necessary implant...
September 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
V L Narayanan, N Balasubramanian
Introduction: Proximal humerus fracture fixation using plate osteosynthesis depends on the quality of the bone, design of the fixation devices and intra-operative soft tissue dissection. This study evaluates the functional outcome of minimally invasive percutaneous plate osteosynthesis using locking compression plate in proximal humerus fracture treatment. Materials and Methods: The study was conducted on 30 patients with complex proximal humerus fractures treated by minimally invasive percutaneous plate osteosynthesis using locking compression plate (PHILOS)...
July 2018: Malaysian Orthopaedic Journal
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