Orthoteers homepage Advertise on Orthoteers
Orthoteers Junior Orthoteers Orthopaedic Biomechanics Orthopaedic World Literature Society Educational Resources Image Gallery About Orthoteers Orthoteers Members search

References - Three-Part fractures of the proximal humerus

Prosthetic arthroplasty for fractures and fracture-dislocations of the proximal humerus.

Tanner MW, Cofield RH
Clin Orthop 1983 Oct;(179):116-28
During the period from 1970 through 1979, proximal humeral arthroplasty with prostheses of the Neer design was performed in 49 shoulders (48 patients) with complex acute or chronic fractures and fracture-dislocations of the proximal humerus. Follow-up evaluation included physical and roentgenographic examination at least two years after surgery for 43 of the 48 patients and averaged 38 months (range, 2-10 years). Of the 43 patients with adequate follow-up evaluation, 16 had acute and 27 (1 bilateral) had chronic fracture problems. Pain relief was satisfactory in all of the 16 shoulders with acute fractures and in 25 of the 28 shoulders with chronic fracture problems. Active abduction averaged 101 degrees in the acute fracture group (range, 35 degrees-160 degrees) and 112 degrees in the chronic fracture group (range, 20 degrees-180 degrees). Complications in shoulders with acute fractures were associated with problems in tuberosity and rotator cuff healing . Complications were more frequent in shoulders with chronic fractures and fracture-dislocations , and were generally related to surgical difficulty, extensive tissue scarring, and distortion of anatomy. The Neer prosthesis affords satisfactory pain relief for both acute and chronic complex fracture-dislocations of the proximal humerus, but the return of function is governed by the security of tuberosity-muscle cuff repair, sufficient protection after operation, and long-term physiotherapy. If possible, surgery should be performed early to avoid the scarring and inelasticity that engender complications and limit functional recovery in shoulders with chronic fractures.



Assessment and management of three-and four-part proximal humeral fractures.

Rees J, Hicks J, Ribbans W
Clin Orthop 1998 Aug;(353):18-29
Department of Orthopaedics, Northampton General Hospital, England.

Three-and four-part comminuted fractures of the proximal humerus are difficult and technically demanding to treat. The various treatment methods reported in the literature are reviewed. It is recommended that three-part fractures be treated with open reduction and internal fixation. Four-part fractures in the younger, active patient also can be treated successfully with open reduction and internal fixation. However, in the elderly and in the patient with osteoporosis, a hemiarthroplasty is the treatment of choice. There is a need for universal agreement on a scoring system for measuring outcome in these fractures to allow a meaningful comparison between reported treatment methods.



This is a preview of the site content. To view the full text for this site, you need to log in.
If you are having problems logging in, please refer to the login help page.


© 2005-2007 Orthoteers.co.uk - last updated by Len Funk on 06 April 2005Medical Merketing and SEO by Blue Medical 
Biomet supporting orthoteersThe British Orthopedic Association supporting OrthoteersOrthoteers is a non-profit educational resource. Click here for more details
Fractures of the shaft of the humer...
Humeral fracture bracing
Proximal Humerus Fractures
References - Three-Part fractures o...
References - Three-Part fractures o...
References - Two-Part surgical neck...
References - Two-Part tuberosity fr...
Hide Menu