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proximal humerus fracture

Chad M Myeroff, Jeffrey P Anderson, Daniel S Sveom, Julie A Switzer
Background: Known possible consequences of proximal humerus fractures include impaired shoulder function, decreased independence, and increased risk for mortality. The purpose of this report is to describe the survival and independence of elderly patients with fractures of the proximal humerus, treated in our institution, relative to patient characteristics and treatment method. Methods: Retrospective cohort study from 2006 to 2012. Setting: Community-based hospital with level 1 designation...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Miltiadis Argyropoulos, Matthew Kent
Background: Open reduction internal fixation of displaced 3 and 4-part proximal humerus fractures is an effective treatment modality particularly for the younger age group, but it is not without complications. Fixed angled locking screw plates are the mainstay of fixation. The A.L.P.S. Proximal Humerus Plating System is a new implant that has smooth locking pegs in the place of humeral head screws to help reduce glenoid damage in the event of cut-out and is designed to sit low on the humerus in order to reduce the risk of subacromial impingement...
2018: Open Orthopaedics Journal
Tao Jiang, Lin Jiang, Jun-de Shi, Yong-Ge Jiang, Du-Liang Liu
OBJECTIVE: To explore the treatment skill and clinical effect of bone setting manipulation in treating proximal humeral fracture with shoulder dislocation. METHODS: From January 2015 to December 2015, 118 cases of proximal humeral fractures with shoulder joint dislocation were treated by bone setting reduction and fixation with adhesive tape or Kirschner wire after reduction, including 56 males and 62 females with an average age of 61 years old ranging from 48 to 88 years old...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Qing-Feng Shen, Xin Wen, Sheng-Wu Yang, Xin Chen, Wei-Xing Fan, Guo-Zhu Xu, Fang-Zheng Yu, Jun-Yi Zhu, Jian Wang
OBJECTIVE: To compare the clinical efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO)and open reduction and internal fixation (ORIF) in treating senile NEER IIproximal humerus fractures. METHODS: From March 2014 to March 2016, 46 elderly patients with Neer II proximal humerus fractures were retrospectively reviewed. Among them, 20 patients in MIPPO group included 9 males and 11 females with an average age of (70.4±4.4) years old; while 26 patients in ORIF group included 11 males and 15 females with an average age of (70...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Shyam Kumar, Ulhas Sonar, Iqbal Singh
The incidence of fragility fractures of the humerus is increasing worldwide. Although clinicians are aware of fractures of hips and wrists, fractures of the shoulder and elbow do not receive much attention. A considerable proportion of the elderly population (estimated at 10-24%) is dependent on walking aids. A well-functioning and pain-free shoulder and elbow is essential for use of these aids. The impact of loss of mobility in the elderly is well known, hence the overall impact of these fractures on the individual can be considerable...
March 2, 2018: British Journal of Hospital Medicine
C Z Esenyel, I Kalkar, M Adaş, S S Dedeoğlu, C D Büyükkurt, H Cabuk, A E Esenyel
Objective: To evaluate the functional and radiological results of patients with and without medial calcar continuity in plate osteosynthesis applied for a proximal humerus fracture retrospectively. Methods: The study included 27 patients to whom plate osteosynthesis was applied because of a proximal humerus fracture between January 2, 2010, and December 30, 2013, at Okmeydanı Research and Training Hospital. Patients were separated into Group A with medial calcar continuity and Group B without medial calcar continuity...
March 2018: Nigerian Journal of Clinical Practice
Andreas Panagopoulos, Irini Tatani, Seferlis Yannis, Bavelou Aikaterini, Antonis Kouzelis, Minos Tyllianakis, Panayotis Dimakopoulos
Background: The valgus-impacted (VI) 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. Objectives: The present study reports the midterm clinical and radiological results of a large series of consecutive patients with 4-part VI fractures treated with a minimal invasive technique of internal fixation. Methods: Over a ten-year period (2004-2014), we treated 56 patients with a true 4-part valgus impacted fracture of the proximal part of the humerus...
2018: Open Orthopaedics Journal
Gang Xue, Kapil Chahal, Thou Lim, Siyuan Hu, Shaohua Li, Jie Liu
PURPOSE: Greater tuberosity fractures (GTFs) account for 17 to 21% of proximal humerus fractures, most of these fractures are treated conservatively, but treatment for displaced fractures is still controversial. The aim of this study is to compare intra-operative clinical conditions and post-operative outcomes when displaced GTFs are treated with either proximal humeral internal locking system (PHILOS) or mini locking plate with trans-osseous sutures. METHODS: This is a retrospective study conducted in Shanghai Tenth People's Hospital...
March 3, 2018: International Orthopaedics
Stefano Carbone, Riccardo Mezzoprete, Matteo Papalia, Valerio Arceri, Andrea Carbone, Stefano Gumina
OBJECTIVE: The objectives of the study were: a) to identify osteoporotic proximal humerus fractures in a large consecutive series of patients; b) to identify radiographic fracture patterns among osteoporotic and non-osteoporotic proximal humerus fractures; and c) to calculate intra- and inter-observer reliability of assessment of osteoporosis and of radiographic fracture patterns. METHODS: This was a prospective observational study of patients admitted to the emergency department affected by a proximal humerus fracture between June 2014 and June 2016...
March 2018: European Journal of Radiology
Minfei Qiang, Xiaoyang Jia, Yanxi Chen, Kun Zhang, Haobo Li, Yuchen Jiang, Yijie Zhang
BACKGROUND Screw perforation and varus collapse are common complications of treatment with a PHILOS (proximal humerus internal locking system) plate for proximal humerus fractures, which are associated with improper screw length selection and lack of medial column support. The purposes of this study were: (1) to measure the proper length of periarticular screws of the PHILOS plate in the humeral head, and (2) to determine what factors influence the screw length and implantation of the inferomedial support screw...
February 25, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Peter Varga, Leonard Grünwald, Markus Windolf
Fixation of osteoporotic proximal humerus fractures has remained challenging, but may be improved by careful pre-operative planning. The aim of this study was to investigate how well the failure of locking plate fixation of osteoporotic proximal humerus fractures can be predicted by bone density measures assessed with currently available clinical imaging (realistic case) and a higher resolution and quality modality (theoretical best-case). Various density measures were correlated to experimentally assessed number of cycles to construct failure of plated unstable low-density proximal humerus fractures (N = 18)...
February 22, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Yeming Wang, Jian Li, Jianhua Yang, Jingming Dong
BACKGROUND: Incidence of proximal humeral fractures dramatically increased over the last decade due to demographic changes. The goal of this study was to analyze regional characteristics of cortical bone in the humeral head region using cortical bone mapping (CBM) technique. METHODS: The proximal humerus of 103 healthy volunteers was imaged by clinical computed tomography (CT) scans. Three groups of volunteers were identified according to age: group A (20-39 years), group B (40-59 years), and group C (>60 years)...
February 16, 2018: Bone
Eric A White, Matthew R Skalski, Dakshesh B Patel, Jordan S Gross, Anderanik Tomasian, Nathanael Heckmann, George R Matcuk
The greater tuberosity is an important anatomic structure and its integrity is important for shoulder abduction and external rotation. Isolated fractures of the greater tuberosity are often subtle and may not be detected on initial radiographs. Clinically, these patients display symptoms which mimic a full thickness rotator cuff tear. It is important to differentiate these two entities, as their treatment is different (typically nonsurgical management for minimally displaced fractures versus rotator cuff repair for acute full thickness rotator cuff tears)...
February 16, 2018: Emergency Radiology
Samir Mehta, Matthew Chin, Jennifer Sanville, Surena Namdari, Michael W Hast
INTRODUCTION: In locked plate fixation of proximal humerus fractures, the calcar is an important anchor point for screws providing much-needed medial column support. Most locking plate implants utilize a fixed-trajectory locking screw to achieve this goal. Consequently, adjustments of plate location to account for patient-specific anatomy may result in a screw position outside of the calcar. To date, little is known about the consequences of "missing" the calcar during plate positioning...
February 11, 2018: Injury
Bill Oxley
OBJECTIVE: To report the use of a 3-dimensional (3D)-printed patient-specific reduction guide system to facilitate minimally invasive plate osteosynthesis (MIPO) of a humeral fracture in a cat. STUDY DESIGN: Case report. ANIMALS: A 9-year-old male neutered domestic short hair cat weighing 4.4 kg. METHODS: A 9-year-old male domestic short hair cat was presented with a comminuted, mid-diaphyseal left humeral fracture. Computed tomographic data were processed to yield 3D mesh representations of both humeri and subsequently manipulated in computer-aided design software...
February 15, 2018: Veterinary Surgery: VS
Joey LaMartina, Kaitlyn N Christmas, Peter Simon, Jonathan J Streit, Jesse W Allert, Jonathan Clark, Randall J Otto, Adham Abdelfattah, Mark A Mighell, Mark A Frankle
BACKGROUND: Decision making in the management of proximal humerus fractures can be difficult in situations in which the surgeon is uncertain of the ideal treatment. METHODS: Two shoulder surgeons operatively treated 476 proximal humerus fractures from 1998-2014 with open reduction-internal fixation (ORIF), hemiarthroplasty, or reverse shoulder arthroplasty. Operative treatment was stratified by year to determine the evolution of technological influences on treatment over time...
March 2018: Journal of Shoulder and Elbow Surgery
S Coyle, S Kinsella, B Lenehan, J M Queally
BACKGROUND: As healthcare systems come under ever-increasing pressure to provide more care with fewer resources, emphasis is being placed on value-based systems that maximise quality and minimize cost. The aim of this study was to determine which interventions in fracture care have been demonstrated to be cost effective. METHODS: A systemic review of cost-utility studies on the management of fractures from 1976 to 2015 was carried out using a search of the Cost-Effectiveness Analysis Registry, National Health Service Economic Evaluation Database (NHS EED) and MEDLINE...
January 31, 2018: Injury
Raffaele Russo, Antonio Guastafierro, Livia Renata Pietroluongo
BACKGROUND: This study regards a volumetric analysis of proximal humeral fractures. The main purpose was to investigate the head displacement in relation to the shaft and its link to volume reductions ("bone loss") of the anatomic segments interposed between the head and the shaft: the tuberosities and the calcar. We call this area "control volume." METHODS: In 20 fractures, we used 3-dimensional virtual reconstruction to create a reference system that divides geometrically the control volume and allows the evaluation of displacement angles of the humeral head...
February 5, 2018: Journal of Shoulder and Elbow Surgery
Towseef Ahmad Bhat, Amara Gulzar, Aejaz Ahmad Bhat, Tariq Ahmad Bhat, Zameer Ali
PURPOSE: Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year. METHODS: Twenty-one consecutive patients over a period of 1 year reported to our department for orthopaedic management of bear maul injuries. All the patients were referred either from peripheral hospitals or from other surgical departments of our hospital. RESULTS: All the patients had facial/scalp injuries of variable severity...
November 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Brandon G Santoni, David M Donohue, T Kyle Stoops, Gregory Tanner, Miguel A Diaz, Mark Mighell
OBJECTIVE: To quantify the stability of 3 points of inferiorly-directed versus 3 points of superiorly-directed locking screw fixation compared to the full contingent of 6 points of locked screw fixation in the treatment of a 3-part proximal humerus fracture. METHODS: A standardized 3-part fracture was created in 10 matched pairs (experimental groups) and 10 non-matched humeri (control group). Osteosynthesis was performed using three locking screws in the superior hemisphere of the humeral head (suspension), three locking screws in the inferior hemisphere (buttress), or the full complement of 6 locking screws (control)...
January 26, 2018: Journal of Orthopaedic Trauma
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