Cham: Springer International Publishing 2015. Comminuted humeral head fractures: a multicenter analysis. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. Hertel R, Hempfing A, Stiehler M, Leunig M. A systematic review of locking plate fixation of proximal humerus fractures. Sproul RC, Iyengar JJ, Devcic Z, Feeley BT. Complications associated with locking plate of proximal humerus fractures. Reverse shoulder arthroplasty for proximal humeral fractures: outcomes comparing primary reverse arthroplasty for fracture versus reverse arthroplasty after failed osteosynthesis. Shannon SF, Wagner ER, Houdek MT, Cross WW 3rd, Sánchez-Sotelo J. Risk factors for humeral head necrosis and non-union after plating in proximal humeral fractures. 2019 28:1674–84.īoesmueller S, Wech M, Gregori M, Domaszewski F, Bukaty A, Fialka C, Albrecht C. Complications after surgical treatment of proximal humerus fractures in the elderly-an analysis of complication patterns and risk factors for reverse shoulder arthroplasty and angular-stable plating. Klug A, Wincheringer D, Harth J, Schmidt-Horlohé K, Hoffmann R, Gramlich Y. Osteonecrosis after surgically repaired proximal humerus fractures is a predictor of poor outcomes. 2018 19:12.īelayneh R, Lott A, Haglin J, Konda S, Zuckerman JD, Egol KA. ![]() ORIF versus arthroplasty for open proximal humerus fractures: Nationwide Inpatient Sample data between 19. 2008 17:42–54.ĭixit A, Cautela FS, Cooper CS, Beyer GA, Messina JC, Mait JE, Shah NV, Diebo BG, Paulino CB, Urban WP. Proximal humeral fractures: a systematic review of treatment modalities. Lanting B, MacDermid J, Drosdowech D, Faber KJ. Outcome measures reported for the management of proximal humeral fractures: a systematic review. Richard GJ, Denard PJ, Kaar SG, Bohsali KI, Horneff JG, Carpenter S, Fedorka CJ, Mamelson K, Garrigues GE, Namdari S, Abboud JA, Paxton ES, Kovacevic D, Hebert-Davies J, Ponce BA, King JJ. Proximal humeral fracture locking plate fixation with anatomic reduction, and a short-and-cemented-screws configuration, dramatically reduces the implant related failure rate in elderly patients. 2020 29:1689–94 This is one of the few studies that include an adequate sample size and follow-up among older patients., 2020.įoruria AM, Martinez-Catalan N, Valencia M, Morcillo D, Calvo E. Locking plate fixation of proximal humerus fractures in patients older than 60 years continues to be associated with a high complication rate. ![]() Barlow JD, Logli AL, Steinmann SP, Sems SA, Cross WW, Yuan BJ, Torchia ME, Sanchez-Sotelo J. ![]() Papers of particular interest, published recently, have been highlighted as: Given the frequent utilization of ORIF and the higher than acceptable complication and failure rates, AVN and PTA warrant our attention. For most patients, rTSA is the optimal treatment option. Careful indications for ORIF may decrease the frequency of these complications. With careful patient selection and meticulous surgical technique, AVN and PTA can be mitigated. Due to satisfactory patient outcomes, reverse total shoulder replacement (rTSA) has increased in popularity for the elderly population, while hemiarthroplasty (HA) may be appropriate for some young, active patients. ![]() Biological supplementation, anatomic total shoulder replacement (aTSA), and fusion are rarely employed in the treatment of AVN and/or PTA. Special consideration is given to the examination of the deltoid muscle, neurovascular status, rotator cuff function, and the possibility of infection. EMG and/or aspiration may also be indicated. This includes a careful patient history, clinical exam, plain film radiographs, and CT scans. A thorough workup is required in the setting of failure caused by AVN and PTA. This is particularly true of complex fracture patterns. Recent best available evidence demonstrates significant rates of AVN and PTA following ORIF of PHF. The mechanisms of treatment options and associated outcomes are also reviewed. This review includes a discussion of incidence, risk factors, and evaluation of AVN and PTA following PHF. Despite the frequent utilization of ORIF, information regarding these leading causes of failure is limited. Avascular necrosis (AVN) and posttraumatic arthritis (PTA) are common complications following both conservative treatment and open reduction and internal fixation (ORIF) of proximal humerus fractures (PHFs).
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