Complex head-splitting fracture–dislocation of the proximal humerus successfully treated with minimal internal fixation: A case report and discussion

Bailie, A. G.; McAlinden, M. Gavan

doi:10.1016/j.injury.2005.08.015

Cited by 4 publications

(7 citation statements)

References 13 publications

(8 reference statements)

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“…6, 7, 9 Women had a higher mean UCLA score; however, there are no published studies to compare this finding. These results are probably related to the lower-energy mechanism of injury in this group, since 72.7% of the women experienced fall to the ground, while the trauma mechanisms in men were higher-energy.…”

Section: Discussionmentioning

confidence: 95%

“…Collopy and Skirving 9 used two cancellous screws as a fixation method, as well as Bailie and McAlinden 6 . Warner et al 4 reported a preference for using screws, whether cannulated or not, for this type of fracture.…”

Section: Discussionmentioning

confidence: 99%

“…In all patients, “trauma series radiographs” (corrected frontal, axillary profile, and scapula profile) were made for fracture classification 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16. Computed tomography was performed in cases where there was doubt as to fracture classification (27 patients).…”

Section: Methodsmentioning

confidence: 99%

“…1). 3 These are usually associated with three- and four-part fractures, are related to high-energy trauma, and usually occur in young patients 2, 3, 6, 7. They are characterized by great involvement of blood supply to the humeral head and its fragments; therefore, they often evolve into necrosis 3 …”

Section: Introductionmentioning

confidence: 99%

“…There are some reports in the literature of isolated cases in which the authors comment on the rarity of the injury 6, 9. Chesser et al 2 described eight patients with epiphyseal fracture, three of whom underwent open reduction and internal fixation (ORIF).…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of non-arthroplasty surgical treatment of proximal humeral head fractures

Miyazaki

Santos

Sella

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveThis study aimed to assess the outcomes of patients with humeral head fractures treated by reduction and osteosynthesis.MethodA total of 53 shoulders (52 patients) with humeral head fractures were operated between October 1996 and December 2009. Patients previously treated with primary arthroplasty and/or those who had less than two years follow-up were excluded. A total of 34 shoulders of 34 patients were therefore reassessed. In the sample studied, 23 patients were male and mean age was 47 years. Cases were assessed based on the UCLA score.ResultsMean post-operative follow-up was 50 months. Twelve patients evolved with excellent outcome, seven good, five regular, and ten with poor outcome (55.8% satisfactory and 44.2% unsatisfactory outcomes). Mean UCLA score was 26 points. Mean post-operative range of motion measurements was 117° elevation, 36° LR and L1 MR. At the immediate post-operative radiography, anatomic reduction was evident in 17 patients (50%). Necrosis was detected in 18 patients, six Grade II and 12 Grade III cases. Female gender and anatomically reduced fractures were statistically better at UCLA scale (p = 0.01 and p = 0.0001 respectively).ConclusionsFemale patients had a higher mean UCLA score than male patients (p = 0.01). Anatomically reduced fractures had higher UCLA scores (p = 0.0001) and lower necrosis rate (p = 0.0001). Reconstruction of humeral head fractures had a satisfactory outcome in 55.8% of cases and should be indicated in young and active patients.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of non-arthroplasty surgical treatment of proximal humeral head fractures

Miyazaki

Santos

Sella

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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Resultados do tratamento cirúrgico não artroplástico das fraturas da epífise proximal do úmero

Miyazaki

Santos

Sella

et al. 2016

Revista Brasileira de Ortopedia

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Subscapularis Peel for Open Reduction and Internal Fixation of Proximal Humerus Fractures With a Head Split

Cherney

Murphy

Achor

et al. 2018

Journal of Orthopaedic Trauma

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Proximal humerus fractures involving an articular head split are rare and complex injuries. In the elderly population, arthroplasty is the optimal treatment, whereas in younger patients, the utility of arthroplasty procedures is limited by concerns of long-term implant survival. As a result, open reduction and internal fixation is still often the first-line treatment option for head-splitting injuries. The traditionally described deltopectoral or anterolateral surgical approaches to the proximal humerus rely on indirect reduction and limited visualization of the articular fragments. We present a case series of younger patients with head-split proximal humerus fractures treated with open reduction and internal fixation through a deltopectoral approach with a subscapularis peel to improve humeral head visualization, reduction, and fixation. The improved reduction may lead to better long-term outcomes and reduce the need for additional surgical procedures. In addition, there were no cases of avascular necrosis in this series.

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Complex head-splitting fracture–dislocation of the proximal humerus successfully treated with minimal internal fixation: A case report and discussion

Cited by 4 publications

References 13 publications

Outcomes of non-arthroplasty surgical treatment of proximal humeral head fractures

Outcomes of non-arthroplasty surgical treatment of proximal humeral head fractures

Resultados do tratamento cirúrgico não artroplástico das fraturas da epífise proximal do úmero

Subscapularis Peel for Open Reduction and Internal Fixation of Proximal Humerus Fractures With a Head Split

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