Plating in Proximal Humeral Fractures

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
R Babst, Felix Brunner

Abstract

Improved imaging, updated knowledge regarding humeral head perfusion and adapted fixation techniques with implants having better purchase also in osteopenic bone, have influenced the treatment of proximal humeral fractures in recent years. Demographic evolution and a more active population even among the older age groups will increase the incidence of this fracture, which is already the third most frequent fracture after hip and distal radius fractures in elderly patients. Long-term morbidity related to the treatment of these fractures like avascular humeral head necrosis, non-union, malunion, shoulder stiffness, persistent pain and functional disability are the challenging factors to be overcome. Plate osteosynthesis with angular stable implants have shown to address some of these problems and to broaden the spectrum of indication towards anatomic fracture stabilization even for severely displaced three- and four-part fractures instead of replacing the humeral head with an endoprosthesis, as long as a stable fixation is possible. Open access surgery is often needed for anatomic reconstruction of complex and displaced fractures. This calls for immediate postoperative mobilization with active-assisted ROM exercise to prevent sub...Continue Reading

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Citations

Mar 5, 2011·Musculoskeletal Surgery·C IacobellisR Aldegheri
Jun 11, 2011·Acta Orthopaedica·Stig BrorsonAsbjørn Hróbjartsson
Jun 2, 2017·The Open Orthopaedics Journal·Dominik SaulKlaus Dresing
May 2, 2014·Journal of Orthopaedic Surgery·Umapathi ChowdaryP Krishna Subramanyam

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