Multifragmentary dislocated humeral head fracture—A case report of a successful head preserving treatment strategy despite delayed presentation

Bungartz, Matthias; Matziolis, Georg; Rohe, Sebastian; Brinkmann, Olaf

doi:10.1016/j.ijscr.2016.10.064

Cited by 2 publications

(4 citation statements)

References 17 publications

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“…The proximal humerus fracture occurs commonly in post-menopausal females and accounts for 6% of all fractures [3] . Although there are randomized controlled studies for management of proximal humerus fractures, these include mainly Neer II and III fractures [4] .…”

Section: Discussionmentioning

confidence: 99%

“…An intact rotator cuff is important for functional outcome as there is associated good osteosynthesis and fracture healing [7] . The prevalence of rotator cuff defects range from 5% to 50% after the initial injury [3] , [7] . Careful dissection during surgery while preserving the rotator cuff mechanism is essential to achieve good outcome.…”

Section: Discussionmentioning

confidence: 99%

“…However, this criteria alone cannot be used for prognostication as bone healing depends on several other factors such as intact blood supply and the state of surrounding soft tissues [8] . There is considerable individual variations in the blood supply of the head of the humerus limiting the ability to predict the outcome [3] .…”

Section: Discussionmentioning

confidence: 99%

“…There is lack of consistent data regarding the outcomes of primary hemiarthroplasty versus secondary hemiarthroplasty after avascular necrosis [10] . In the event of avascular necrosis after k-wire fixation, a reverse shoulder arthroplasty or a hemiarthroplasty may be considered as a salvage procedure [3] , [11] .…”

Section: Discussionmentioning

confidence: 99%

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Multifragmentary proximal humerus fracture successfully treated with k-wire fixation: A case report

Jayarajah

Amarasooriya

Sooriyarachchi

2021

International Journal of Surgery Case Reports

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Introduction and importance The ideal treatment of proximal humerus fracture remains a controversial topic, especially in the case of complex multi-fragmentary fractures. However, in limited resource settings, alternative less complicated fixation may be considered in highly selected patients without compromising the functional outcome. We report a case of successful treatment with k-wire fixation with satisfactory functional outcome. Case presentation A 22-year-old female presenting with a right-sided closed multi-fragmentary proximal humerus fracture following a motor vehicle collision. A complex multi-fragmentary right-sided proximal humerus fracture (AO 11C3, Codman-Hertel type 12) was diagnosed based on the shoulder x-ray and computed tomography 3-dimensional reconstruction. She underwent an open reduction and k-wire fixation under image guidance. She had satisfactory functional outcome 6 months after surgery with painless near-total range of motion. Clinical discussion The ongoing debate of the optimal surgical management for complex proximal humerus fractures implies that the best treatment should be made on an individual basis. The probable reason for the good outcome in our patient may be the combination of intact blood supply and periosteum, intact rotator cuff mechanism, young patient with healthy bone metabolism and achievement of good reduction with restoration of the articular surface and calcar. Conclusion Although this successful case of k-wire fixation is not sufficient to challenge the option of primary arthroplasty, this low cost, readily, available simple strategy may be useful in highly selective instances.

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Section: Discussionmentioning

confidence: 99%