Related Papers
Characteristics of Effective and Safe Methods of Treatment for Fresh Fracture-Dislocations of the Proximal Humerus
2020 •
Leonid Solomin
Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proximal humerus (PH) within different time frames for optimizing treatment tactics. Patients and Methods This retrospective cohort study evaluated clinical outcomes of 25 patients with fracture-dislocations of the PH (15 patients were analyzed for short- and medium-term results, and 10 – for long-term results). The follow-up period ranged from 1 to 9-years. All patients underwent: clinical examination, constant score assessment and shoulder X-ray examination. Clinical, radiological and statistical methods were used for analysis. Results Assessment of the degree of initial displacement of tubercles and its impact on the results of treatment showed that significantly better results were obtained in case of displacement no more than 10 mm (p=0.041). Patients with displacement no more than 10 mm had an average score of 68.0±16.1 points (Mean=69.5), while those with displacement of the tubercle(s...
Complex Proximal Humeral Fractures (Three or Four Part) with Dislocation: Outcome Analysis of Percutaneous Reduction and External Fixation
Sohael M Khan
Journal of Clinical Medicine
Promising Mid-Term Outcomes after Humeral Head Preserving Surgery of Posterior Fracture Dislocations of the Proximal Humerus
2021 •
Michael Raschke
Background: The aim of this study was to evaluate the clinical outcome after humeral head preserving surgical treatment of posterior fracture dislocations of the proximal humerus. Methods: Patients with a posterior fracture dislocation of the proximal humerus that were operatively treated in two level-1 trauma centers within a timeframe of 8 years were identified. With a minimum follow-up of 2 years, patients with humeral head preserving surgical treatment were invited for examination. Results: 19/24 fractures (79.2%; mean age 43 years) were examined with a mean follow-up of 4.1 ± 2.1 years. Of these, 12 fractures were categorized as posteriorly dislocated impression type fractures, and 7 fractures as posteriorly dislocated surgical neck fractures. Most impression type fractures were treated by open reduction, allo- or autograft impaction and screw fixation (n = 11), while most surgical neck fractures were treated with locked plating (n = 6). Patients with impression type fractures ...
Injury
Four-part fracture dislocations of the proximal humerus in young adults: Results of fixation
2013 •
Wael Koptan
Injury Extra
Complex head-splitting fracture–dislocation of the proximal humerus successfully treated with minimal internal fixation: A case report and discussion
2006 •
Gavan McAlinden
International Journal of Research in Medical Sciences
Evaluation of results of three and four-part fracture dislocations of proximal humerus in young adults using philos (proximal humerus internal locking system)
Sumeet Singh Charak
Background: The fractures of proximal humerus constitute about 5% of fractures in adults third in number to fracture colles and hip usually in elderly patients due to a low energy trauma. In young patients the fractures are mostly due to high energy trauma and as such are associate with other soft tissue injuries. A sub group of young patients have a three or four fracture dislocation of shoulder joint. The aim of this study was to find the results of fixation by PHILOS in these young patients.Methods: This study was done in a teritiary referral centre over a period of about 1 year. All patients were operated within three weeks. Open fractures, patients with age more than 50 years were excluded from the study. All patients underwent open reduction and fixation using commercially available PHILOS. A minimum of 6 months follows up was essential for inclusion into the study. Final functional results were evaluated by Constant Murley scoring.Results: 14 patients were included in the stu...
Comprehensive Study of Surgical management of Proximal Humerus fractures in adults-A REVIEW ARTICLE
IOSR Journals
The majority of proximal humerus fractures are treated nonoperatively with good functional results. Multiple options exist for treating displaced fractures, without a clear advantage of any one method for a given fracture type. Goals include an adequate reduction and stable fixation to initiate early motion and rehabilitation. Decision-making should be based on patient and injury specifics and surgeon's experience. Various types of fixation, including plates, nails, or percutaneous pins, can maintain sufficient stability to promote shoulder mobility and function. Any of these methods will have few complications when undertaken with appropriate patient selection and careful surgical technique.Locked plating may improve fracture stability in some complex patterns and facilitate early rehabilitation. It is possible that some fractures previously treated with hemiarthroplasty may be managed successfully with locking plates. Prospective study to assess the complications, outcomes, and cost effectiveness of nonoperative management compared to various surgical treatment options is warranted.
IP Innovative Publication Pvt. Ltd
Surgical management of proximal humerus fractures – Assessment of results
2017 •
IP Innovative Publication Pvt. Ltd., Jeewaka de Zoysa
Introduction: Proximal humeral fracture whether caused by trauma or related to osteoporosis, requires carefully planned individual treatment. The choice of technique and devices depends on quality of bone, soft tissue, age and reliability of patients. However the goal of proximal humerus fracture fixation should be stable reduction, allowing early motion of fracture. Objectives: To analyze fractures of the proximal humerus that were treated either with the proximal humerus internal locking system (PHILOS) locking plate or percutaneous K wire and document their clinical and functional outcome. Materials and Method: The study includes patients with proximal humerus fractures who underwent Open reduction and internal fixation with PHILOS locking plate or Percutaneous K-wire fixation. Functional outcome was evaluated by Constant-Murley score. Patients were followed up at 6 weekly interval until fracture union and at once at 1 yr after the surgery 30 cases were studied, cases were selected randomly for both PHILOS and percutaneous k wire fixation, each 15 cases. Results: 33.34% patients treated with open reduction and internal fixation with PHILOS plating had good to excellent results, 46.6% of patients had fair results and the remaining 20% had poor results. 40% of patients treated with closed reduction and K wire fixation had good to excellent results, 40% of patients had fair results and remaining 20% had poor results. Conclusion: The results of surgical treatment of proximal humerus fractures in both the groups (percutaneous pinning and PHILOS plating) are satisfactory with good functional outcome.
Singapore medical journal
Evolving trends in surgically managed patients with proximal humerus fracture: are we different after ten years?
Diarmuid P Murphy
New knowledge, and improved surgical hardware and fi xation techniques have changed surgical management. We review the evolving trends of surgically managed proximal humerus fractures. Patients who underwent surgery for proximal humerus fractures from 1 January 2001 to 31 December 2010 were identified from the hospital's electronic diagnosis and operative coding database. Data extracted from the database included patient demographics, comorbidities, clinical and radiological findings, operative techniques, and complications. In total, 95 patients with 97 surgically managed proximal humerus fractures were identified. The median age of the patients was 50 (range 12-85) years, and the male to female ratio was 1.2:1.0. Male patients tended to present at a younger age than female patients (peak age 30-39 years vs. 70-79 years, p < 0.001). Two-part surgical neck fracture was the most common type of fracture (n = 33, 34.0%). Plate osteosynthesis was predominantly used for two- and t...
IOSR Journals
Study of Functional Outcome of Surgical Management of Proximal Humerus Fracture by Various Modalities
2019 •
IOSR Journals
Fractures of the proximal humerus are complex injuries with significant morbidity .Although various options of management available including non-operative management are present the choice of treatment depends upon the pattern of the fracture, the quality of the bone encountered, the patient's goals and the surgeon's familiarity with the techniques. The aim of this study was to review the functional, radiographic results and complications of the operative procedure in a series of twenty patients. Over a two year period we treated twenty patients with two part fractures, three part fractures, four part fractures and fracture dislocations. Initial pre operative clinical and radiological assessment was done and appropriate mode of treatment of given depending upon type of fracture according Neer's classification. Follow up of patient was done both clinically and radiologically at 2nd, 6th and 8th weeks and assessed for any complications. Final assessment was done according to Neer's shoulder scoring criteria. Eight patients were treated with Locking Compression Plate, eight patients were treated with K-wires and cancellous screws, three patient were treated by interlocking nail, remaining one underwent hemi-arthroplasty. All fractures united with an average of 17.7 weeks and no patients had signs of malunion, non-union osteonecrosis of the humeral head on the latest follow up radiographs. In the overall results analyzed in our series 70% of the patients had excellent and satisfactory results and 30% had unsatisfactory and failure outcome. There is direct relationship in displaced proximal humeral fractures between fracture severity i.e. displacement and communition, and the eventual results.That is more the initial insult, worse the prognosis. Internal fixation of fractures of proximal end of humerus produced good functional outcome and fewer complications. Rehabilitation is the key to success
