Proximal humerus fractures with valgus deformity of the humeral head: The spectrum of injury, clinical assessment and treatment

Robinson, C. M.; Longino, David; Murray, Iain R.; Duckworth, Andrew D.

doi:10.1016/j.jse.2010.06.002

Cited by 19 publications

(28 citation statements)

References 47 publications

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“…Despite this, most reports on the outcome of such fractures focuses on operative treatment. [12][13][14] There is a paucity of literature reporting the outcome of the conservative management of proximal humeral fractures in the elderly. 15 In this study we describe the mortality and the function of the shoulder for elderly and super-elderly patients one year after a proximal humeral fracture.…”

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confidence: 99%

The outcome of proximal humeral fractures in the elderly

Clement

Duckworth

McQueen

et al. 2014

The Bone & Joint Journal

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This study describes the epidemiology and outcome of 637 proximal humeral fractures in 629 elderly (≥ 65 years old) patients. Most were either minimally displaced (n = 278, 44%) or two-part fractures (n = 250, 39%) that predominantly occurred in women (n = 525, 82%) after a simple fall (n = 604, 95%), who lived independently in their own home (n = 560, 88%), and one in ten sustained a concomitant fracture (n = 76, 11.9%). The rate of mortality at one year was 10%, with the only independent predictor of survival being whether the patient lived in their own home (p = 0.025). Many factors associated with the patient's social independence significantly influenced the age and gender adjusted Constant score one year after the fracture. More than a quarter of the patients had a poor functional outcome, with those patients not living in their own home (p = 0.04), participating in recreational activities (p = 0.01), able to perform their own shopping (p < 0.001), or able to dress themselves (p = 0.02) being at a significantly increased risk of a poor outcome, which was independent of the severity of the fracture (p = 0.001). A poor functional outcome after a proximal humeral fracture is not independently influenced by age in the elderly, and factors associated with social independence are more predictive of outcome.

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confidence: 99%

The outcome of proximal humeral fractures in the elderly

Clement

Duckworth

McQueen

et al. 2014

The Bone & Joint Journal

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“…1 ) and the management applied have differed in most studies. 1 , 2 , 3 , 4 , 5 This lack of consensus in the literature may give rise to failure in prognostic evaluations on these fractures and influence the choice of treatment method.…”

Section: Introductionmentioning

confidence: 99%

“…These fractures have received attention that differentiates them from other complex fractures of the proximal humerus, because of their better prognosis with regard to surgical reduction, consolidation and occurrences of avascular necrosis. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 …”

Section: Introductionmentioning

confidence: 99%

“…The mechanism for these fractures consists of axial trauma to the abducted upper limb, with direct impaction between the humeral head and the glenoid cavity, and consequent impaction and posteromedial displacement (dorsal tilting of the head) because of its physiological anatomical conformation in retroversion. 1 , 2 , 8 , 10 , 12 In this specific type of fracture, with metaphyseal bone impaction, the posteromedial periosteum of the humeral head (i.e. the medial hinge) may be maintained.…”

Section: Introductionmentioning

confidence: 99%

“…2 ). 1 , 2 , 3 , 6 , 8 , 9 , 10 , 11 , 12 , 13 This may give rise to avoidance of the most frequent complication of complex fractures of the proximal humerus: avascular necrosis. The incidence of this complication is 21–75% in four-part fractures and 8–26% in situations of valgus impact.…”

Section: Introductionmentioning

confidence: 99%

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Impacted valgus fractures of the proximal humerus

Ribeiro

Takesian

Bezerra

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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Impacted valgus fractures of the proximal humerus are considered to be a special type fracture, since impaction of the humeral head on the metaphysis with maintenance of the posteromedial periosteum improves the prognosis regarding occurrences of avascular necrosis. This characteristic can also facilitate the reduction maneuver and increase the consolidation rate of these fractures, even in more complex cases. The studies included were obtained by searching the Bireme, Medline, PubMed, Cochrane Library and Google Scholar databases for those published between 1991 and 2013. The objective of this study was to identify the most common definitions, classifications and treatment methods used for these fractures in the orthopedic medical literature.

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Indikation zur primären Frakturendoprothetik der Schulter

Kirchhoff

Biberthaler

2013

Unfallchirurg

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Although fractures of the proximal humerus are one of the most common osteoporotic fracture types, no generally accepted treatment algorithm exists in the current literature. For young patients with high functional demands and good rehabilitation potential, we recommend humeral head salvage therapy. If symptomatic humeral head necrosis occurs, the implantation of an anatomic endoprothesis is possible on a secondary basis. For patients with a biological age > 70 years suffering from a persisting defect of the rotator cuff along with a humeral head fracture or from a multiple fragment fracture of the humeral head, we increasingly prefer implantation of a reverse shoulder prosthesis due to good clinical results. However, because of technical aspects and a high complication rate, treatment using the reverse fracture prosthesis should be reserved for surgeons with expertise in this particular field. After analyzing the fracture- and patient-specific risk factors and performance expectations, the trauma surgeon can select the best individual therapy with the patient.

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Proximal humerus fractures with valgus deformity of the humeral head: The spectrum of injury, clinical assessment and treatment

Cited by 19 publications

References 47 publications

The outcome of proximal humeral fractures in the elderly

The outcome of proximal humeral fractures in the elderly

Impacted valgus fractures of the proximal humerus

Indikation zur primären Frakturendoprothetik der Schulter

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