The Treatment of Proximal Humeral Fracture in Adults

Burkhart, Klaus J.; Dietz, Sven-Oliver; Bastian, L.; Thelen, Ulrich; Hoffmann, Reinhard; Müller, Lars Peter

doi:10.3238/arztebl.2013.0591

Cited by 53 publications

(58 citation statements)

References 24 publications

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“…Mean age of the patients was 56 years (range, 35-72 years). Fall while walking (22) was the most common mode of injury followed by fall from height (3) and road traffic accident (2). Average time between injury to surgery was 7 days (range, 1-20 day/s).…”

Section: Resultsmentioning

confidence: 99%

“…Although proximal humeral fracture is a common type of fracture, very few randomized trials of its treatment have been published. The wide variety of fracture morphologies and treatment options, ranging from conservative treatment to various osteosynthesis methods to the implantation of an endoprosthesis, makes such trials difficult to initiate [2] . It is universally recognized that non-displaced fractures can be treated conservatively.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of functional outcomes of a modified technique for percutaneous pinning of proximal humeus fracture

Kelkar¹,

Mundra²

2018

Int. J. Orthop. Sci.

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Introduction: Proximal humeral fractures are extremely common injuries, and are one of the true osteoporotic fractures. For those that have moderate to severe displacement, the optimal treatment for the patient has not been fully elucidated. The purpose of this study was to evaluate the functional outcome of a modification of percutaneous K-wire fixation technique. Material and methods: A prospective study was performed on all patients diagnosed with intra-articular proximal humerus fracture presenting to us from June 2013 to June 2016. Only patients with closed, displaced two or three part fractures as per Neer's classification were included in the study. Fractures were managed by close reduction and percutaneous pinning with K wires which were linked by a fixator rod using clamps. Patients were evaluated for functional outcome using the Constant score. Results: Twenty seven patients comprising of 18 females and 9 males were followed for an average period of 14 months. Mean age of the patients was 56 years. Fall while walking was the most common mode of injury followed. Mean Constant Score of patients was 77.2. All patients achieved full functional range of motion by the end of 4 months. No nerve injury was reported. Conclusion:Modified technique for percutaneous Kwire fixation using the fixator mini clamps and rods is an effective and economical method allowing biological preservation with good results.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of functional outcomes of a modified technique for percutaneous pinning of proximal humeus fracture

Kelkar¹,

Mundra²

2018

Int. J. Orthop. Sci.

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“…There is a major debate about the question of whether to treat the individual patient nonsurgically or operatively [2,12]. In 1970, Charles Neer introduced a proximal humerus fracture (PHF) classification and found in his own hospital-based patient population that 85 % of fractures were nondisplaced and could be treated conservatively [16].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and treatment reality of proximal humeral fractures at a level-1 trauma center

et al. 2016

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“…1,2 This fracture occurs with an incidence of 105-342 per 100,000 persons per year. 3 It is the third most common fracture type in patients older than sixty-five, 4 and seventh most common fracture type overall. 5 Systematic reviews have revealed that more data are needed to determine the ideal treatment of proximal humerus fractures.…”

Section: Introductionmentioning

confidence: 99%

“…With regard to treatment, non-operative management, operative reduction and internal fixation (ORIF) and arthroplasty have all been debated in the literature, with arguments for and against each, some particular to older patients. 3,4,11,12 We sought to determine if there is a chronological age after which the benefits of operative treatment for proximal humerus fractures decay. Towards this end we compared a cohort of patients aged seventy or greater to a younger elderly group aged fifty-five to sixty-nine, all treated operatively using a locking plate for proximal humerus fractures.…”

Section: Introductionmentioning

confidence: 99%

Operative repair of proximal humerus fractures in septuagenarians and octogenarians: Does chronologic age matter?

Goch

Christiano

Konda

et al. 2017

Journal of Clinical Orthopaedics and Trauma

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A B S T R A C TBackground: With an expected doubling of the geriatric population within the next thirty years it is becoming increasingly important to determine who among the elderly population benefit from orthopaedic interventions. This study assesses post-operative outcomes in patients aged seventy or greater who sustained a proximal humerus fracture and were treated surgically as compared to a younger geriatric cohort to determine if there is a chronologic age after which post-operative outcomes significantly decline. Methods: A retrospective chart review was conducted for 201 patients who sustained fractures of the proximal humerus (OTA 11A-C) and were treated operatively by open reduction and internal fixation. Data from 132 independent, active patients aged fifty-five or older was identified and analyzed. Forty-seven patients age 70 or older were compared to 78 patients aged 55-69. Average length of followup was 19.5 months. All complications were recorded. Univariate and multivariate analysis was conducted to assess for differences between groups. Results: 95% of patients achieved fracture union within 6 months. No significant differences were found between cohorts with regard to gender, fracture severity, or CCI (p = 0.197, p = 0.276, p = 0.084, respectively). Functional outcome scores, shoulder range of motion, and complications rates for patients aged 70 and older were not significantly different from patients aged 55-69. There were 10 complications in the older elderly cohort (21%), 6 of which required re-operation and 13 complications in the young elderly cohort (17%), 8 of which required re-operation. Conclusions: Operative fracture repair using locked plating of the proximal humerus in septuagenarians and octogenarians can provide for excellent long-term outcomes in appropriately selected patients. These patients tend to have long term functional outcome scores, post-operative range of motion, and complication rates that are comparable to younger geriatric patients. Physicians should not exclude patients for repair of proximal humerus fractures based on chronological age cutoffs.Published by Elsevier B.V. on behalf of Delhi Orthopedic Association.

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The Treatment of Proximal Humeral Fracture in Adults

Cited by 53 publications

References 24 publications

Evaluation of functional outcomes of a modified technique for percutaneous pinning of proximal humeus fracture

Evaluation of functional outcomes of a modified technique for percutaneous pinning of proximal humeus fracture

Epidemiology and treatment reality of proximal humeral fractures at a level-1 trauma center

Operative repair of proximal humerus fractures in septuagenarians and octogenarians: Does chronologic age matter?

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