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proximal humerus fracture

M Ghert, M McKee
No abstract text is available yet for this article.
October 2016: Bone & Joint Research
H H G Handoll, S D Brealey, L Jefferson, A Keding, A J Brooksbank, A J Johnstone, J J Candal-Couto, A Rangan
OBJECTIVES: Accurate characterisation of fractures is essential in fracture management trials. However, this is often hampered by poor inter-observer agreement. This article describes the practicalities of defining the fracture population, based on the Neer classification, within a pragmatic multicentre randomised controlled trial in which surgical treatment was compared with non-surgical treatment in adults with displaced fractures of the proximal humerus involving the surgical neck...
October 2016: Bone & Joint Research
S Sabharwal, N K Patel, D Griffiths, T Athanasiou, C M Gupte, P Reilly
OBJECTIVES: The objective of this study was to perform a meta-analysis of all randomised controlled trials (RCTs) comparing surgical and non-surgical management of fractures of the proximal humerus, and to determine whether further analyses based on complexity of fracture, or the type of surgical intervention, produced disparate findings on patient outcomes. METHODS: A systematic review of the literature was performed identifying all RCTs that compared surgical and non-surgical management of fractures of the proximal humerus...
October 2016: Bone & Joint Research
Jonathan J E White, John R Soothill, Marie Morgan, David I Clark, Marius P Espag, Amol A Tambe
BACKGROUND: A large metaphyseal volume shoulder hemiarthroplasty has been in use within our department since 2008; however, no clinical outcome data are available for this prosthesis apart from the designer surgeon series. MATERIALS AND METHODS: During a 5-year period, data were collected for 40 patients (30 women, 10 men) treated consecutively with the Zimmer Anatomical Shoulder Fracture hemiarthroplasty system (Zimmer, Warsaw, IN, USA). RESULTS: The final analysis included 26 patients...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Laurent Obert, Christelle Peyron, Etienne Boyer, Gauthier Menu, François Loisel, Sébastien Aubry
INTRODUCTION: The shoulder arthroplasty brings satisfaction to patients in terms of quality of life and indolence. However whether anatomic implant or reverse, it does not escape from the loosening of the glenoid component. Moreover, optimal implantation is required to ensure the functional outcome without shortening of the arm. The purpose of this study is obtain CT scan evaluation of the glenoid bone stock in order to optimize glenoid component implantation and obtain a reference to determine optimal humeral component placement in case of humeral proximal fracture...
2016: SICOT-J
Michael E Steinhaus, David M Dare, Lawrence V Gulotta
The treatment of displaced proximal humerus fractures is challenging and complex, as its success is predicated on multiple factors. While it is clear that a majority of proximal humerus fractures may be treated nonoperatively, it is less clear which patients benefit from surgical management. The PROFHER trial, a randomized controlled study, used patient-reported outcomes to compare surgical to nonsurgical management of displaced proximal humerus fractures. The purpose of this review is to highlight the strengths and weaknesses of the PROFHER trial and to assess the validity of its conclusion in the context of existing literature...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Adamah Amouzougan, Ludovic Lafaie, Hubert Marotte, Delphine Dẻnariẻ, Philippe Collet, Béatrice Pallot-Prades, Thierry Thomas
INTRODUCTION: Alzheimer's disease or other Dementias (ADD) and postmenopausal osteoporosis are two major public health problems with a huge impact on mortality. Here, we examined the prevalence of ADD in postmenopausal women with osteoporosis, monitored within a dedicated fracture liaison service. METHODS: We conducted a cross-sectional observational study in a population of 2041 women, visiting the university hospital of Saint-Etienne for a peripheral fragility fracture...
September 30, 2016: Joint, Bone, Spine: Revue du Rhumatisme
C D Smith, S J Booker, H S Uppal, J Kitson, T D Bunker
AIMS: Despite the expansion of arthroscopic surgery of the shoulder, the open deltopectoral approach is increasingly used for the fixation of fractures and arthroplasty of the shoulder. The anatomy of the terminal branches of the posterior circumflex humeral artery (PCHA) has not been described before. We undertook an investigation to correct this omission. PATIENTS AND METHODS: The vascular anatomy encountered during 100 consecutive elective deltopectoral approaches was recorded, and the common variants of the terminal branches of the PCHA are described...
October 2016: Bone & Joint Journal
Salvi Prat, Santiago Gallardo-Villares, Marian Vives, Ana Carreño, Marta Caminal, Irene Oliver-Vila, Daniel Chaverri, Margarita Blanco, Margarita Codinach, Pere Huguet, José Ramírez, Javier A Pinto, Màrius Aguirre, Ruth Coll, Joan Garcia-López, Fernando Granell-Escobar, Joaquim Vives
Pseudoarhtrosis is a relatively frequent complication of fractures, in which the lack of mechanical stability and biological stimuli results in the failure of bone union, most frequently in humerus and tibia. Treatment of recalcitrant pseudoarthrosis relies on the achievement of satisfactory mechanical stability combined with adequate local biology. Herein we present two cases of atrophic pseudoarthrosis that received a Tissue Engineering Product (TEP) composed of autologous Bone Marrow-derived Mesenchymal Stromal Cells (BM-MSC) combined with deantigenised trabecular bone particles from tissue bank...
September 29, 2016: Journal of Tissue Engineering and Regenerative Medicine
Y Wu, P Shang, L Che, T Ye, L Wang, S Qiu
In order to minimize the bias of Constant score we modified the allocation of strength subscore. One hundred and two patients with 3- and 4-part proximal humerus fractures were treated using locking plate fixation and followed up for > 1 year. The clinical outcomes were assessed by DASH score abbreviated Constant score (AbbCS strength item excluded) modified Constant score (ModCS with 12-pound strength) and original Constant score (CS with 25-pound strength). The satisfaction rate was determined for each scoring instrument...
August 2016: Acta Orthopaedica Belgica
Khodamorad Jamshidi, Farid Najd-Mazhar, Farshad Abolghasemzadeh Ahangar, Alireza Mirzaei
BACKGROUND: Limb salvage following the resection of tumor from the proximal part of the humerus, poses many challenges, and there is no consensus regarding the best reconstructive technique after proximal humerus resection. The aim of this study was to evaluate the effect of anteromedial placing of the plate in the absence of deltoid muscle and cement augmentation on the functional outcome, complication rate and survival of proximal humerus allograft reconstruction. PATIENTS AND METHODS: A number of 36 osteoarticular allograft reconstructions of proximal humerus were included in final study...
September 25, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Dominique M Rouleau, G Yves Laflamme, Jennifer Mutch
BACKGROUND: This is a retrospective prognostic study on soft tissue injury following isolated greater tuberosity (GT) fractures of the proximal humerus with respect to the relationship between rotator cuff tears and GT displacement. METHODS: Forty-three patients with isolated GT fractures were recruited and evaluated with a standardized interview and physical examination, quality of life and shoulder function questionnaires (Western Ontario Rotator Cuff Index, SF-12 Version 2, Constant, Quick-Disabilities of the Arm, Shoulder and Hand, Visual Analogue Scale), standard shoulder radiographs and an ultrasound...
October 2016: Shoulder & Elbow
L A Archer, A Furey
PURPOSE: Avascular necrosis (AVN) of the humeral head is a devastating complication of proximal humeral fracture (PHF) that often results in long-term morbidity for the patient. Rates of AVN depend on the number of fracture fragments and are highly variable. The literature suggests that timely stable and anatomic reduction may decrease the rate at which AVN develops after PHF. To our knowledge, there is no literature published investigating a temporal relationship between the timing of PHF fixation and rates of AVN...
September 20, 2016: Musculoskeletal Surgery
James E Moyer, Jennifer M Brey
Shoulder injuries in pediatric athletes are typically caused by acute or overuse injuries. The developing structures of the shoulder lead to injury patterns that are distinct from those of adult athletes. Overuse injuries often affect the physeal structures of the proximal humerus and can lead to pain and loss of sports participation. Shoulder instability is common in pediatric athletes, and recurrence is also a concern in this population. Fractures of the proximal humerus and clavicle are typically treated with conservative management, but there is a trend toward surgical intervention...
October 2016: Orthopedic Clinics of North America
Sonya Khurana, Roy I Davidovitch, Young K Kwon, Joseph D Zuckerman, Kenneth A Egol
BACKGROUND: In order to compare open reduction and internal fixation (ORIF) with locked plating to hemiarthroplasty for the treatment of three- and four-part proximal humerus fractures, we compared two groups of patients treated during the same time period. MATERIALS AND METHODS: Sixty-five patients who underwent repair of a three- or four-part proximal humerus fracture with locked plates (Group A) were identified in a prospective database and were compared to 29 patients who underwent hemiarthroplasty for similar injuries (Group B)...
September 2016: Bulletin of the Hospital for Joint Diseases
Kimona Issa, Casey M Pierce, Todd P Pierce, Matthew R Boylan, Bashir A Zikria, Qais Naziri, Anthony Festa, Vincent K McInerney, Anthony J Scillia
INTRODUCTION: Total shoulder arthroplasty (TSA) has become a popular and successful surgery to treat advanced glenohumeral arthritis, rotator cuff arthropathy, and proximal humerus fractures. Historical data is available investigating the epidemiology of total shoulder arthroplasty with regard to patient characteristics, outcomes, and complications; however, there is a lack of studies investigating the most recent and up to date national trends related to shoulder replacement. The purpose of this study was to evaluate changes in the annual incidence, various demographics, and complications of TSA in America...
September 10, 2016: Surgical Technology International
M Hackl, S Lappen, W F Neiss, M Scaal, L P Müller, K Wegmann
BACKGROUND: Olecranon osteotomy is an established approach for the treatment of distal humerus fractures. It should be performed through the bare area of the proximal ulna to avoid iatrogenic cartilage lesions. OBJECTIVES: The goal of this study was to analyze the anatomy of the proximal ulna with regard to the bare area and, thereby, to optimize the hitting area of the bare area when performing olecranon osteotomy. MATERIALS AND METHODS: The bare areas of 30 embalmed forearm specimens were marked with a radiopaque wire and visualized three-dimensionally with a mobile C‑arm...
October 2016: Der Orthopäde
Cem Çelik, Seyit Ali Gümüştaş, Gültekin Sıtkı Çeçen, Güven Bulut, Halil İbrahim Bekler
BACKGROUND: The present objective was to retrospectively evaluate factors affecting functional outcome of multipart proximal humeral fracture treated with fixation or hemiarthroplasty. METHODS: Included were 58 patients (19 women, 39 men; average age: 51.04 years; range 22-78 years) who underwent surgery for Neer type III or IV proximal humeral fractures between 2007 and 2012. All participants attended follow-up of at least 2 years. A total of 35 patients underwent open reduction and anatomical plate fixation; 23 underwent partial shoulder replacement...
July 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Ashok S Gavaskar, Bhupesh Karthik B, Naveen C Tummala, Parthasarathy Srinivasan, Hitesh Gopalan
OBJECTIVES: Humeral head sacrificing procedures are more favored in elderly patients with complex proximal humerus fractures because of high incidence of failures and complications with osteosynthesis. The purpose of this study is to assess the outcome of second generation locked plating techniques in 3 and 4 part fractures in active elderly patients >70years with an emphasis on function and complications. MATERIALS AND METHODS: 29 patients with displaced 3 and 4 part proximal humerus fractures were treated using the principles of second-generation proximal humerus locked plating...
August 24, 2016: Injury
Tae In Kim, Jun Ha Choi, Sae Hoon Kim, Joo Han Oh
BACKGROUND: The purpose of this study was to evaluate whether physicians' practice was adequate for the diagnosis and treatment of osteoporosis in patients with proximal humeral fracture over the age of 50 years, which is one of major osteoporotic fractures. METHODS: A retrospective nation-wide cohort study was performed using data collected in 2010 by the Korean Health Insurance Review Agency. The incidences of fractures around the hip, spine, and proximal humerus in patients more than 50 years of age, the frequencies of diagnostic bone density scan for osteoporosis, and the prescription for the osteoporosis medication were analyzed and compared...
September 2016: Clinics in Orthopedic Surgery
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