Humeral head inferior subluxation in proximal humerus fractures

Carbone, Stefano; Papalia, Matteo; Arceri, Valerio; Placidi, Stefano; Carbone, Andrea; Mezzoprete, R

doi:10.1007/s00264-017-3682-0

Cited by 8 publications

(18 citation statements)

References 13 publications

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“…Not surprisingly, we found that higher energy trauma (motor vehicle collision, High energy falls >3 m and Sports), increased the likelihood of pseudosubluxation. The higher level of trauma may result in more hemarthrosis, neuropraxia and deltoid paresis, leading to pseudosubluxation [10]. On the other hand, we did not find that treatment methods were associated with pseudosubluxation.…”

Section: Discussioncontrasting

confidence: 70%

“…This variation may be due to the greater incidence and variety of comorbidities in adults [3,13]. Humeral head subluxation has been associated with stroke, osteoporosis, diabetes, obesity and smoking [3,10,13]. Also, associated soft tissue injuries are frequently noted in adults, including tears to the labrum associated with greater tuberosity fractures and glenohumeral instability following rotator cuff injuries in adults [14,15].…”

Section: Discussionmentioning

confidence: 99%

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Radiographic pseudosubluxation of the shoulder in pediatric proximal humeral fractures

Torrez

Seidenstein²,

DeBell³

et al. 2021

Journal of Pediatric Orthopaedics B

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Radiographic pseudosubluxation of the shoulder in pediatric proximal humeral fractures

Torrez

Seidenstein²,

DeBell³

et al. 2021

Journal of Pediatric Orthopaedics B

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“…Humeral head pseudosubluxation (HHPS) in relation to the glenohumeral joint is a common radiographic finding following fractures of the proximal humerus. 3 , 5 , 10 , 20 , 23 First described in 1921 after uncomplicated nonoperative treatment of humeral neck fractures, HHPS was poorly understood, with muscle fatigue proposed as the primary mechanism. 6 More recently, the temporary inferior subluxation of the humeral head has been theorized to be an indication of deltoid muscle dysfunction secondary to injury to the axillary nerve.…”

mentioning

confidence: 99%

“…9 , 16 In fewer cases, it has also been described following atraumatic hemarthrosis, cerebrovascular accident, and sepsis. 2 , 3 , 24 , 26…”

mentioning

confidence: 99%

Incidence and risk factors for pseudosubluxation of the humeral head following proximal humerus fracture

Cirino¹,

Kantrowitz²,

Cautela³

et al. 2022

JSES International

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“…Inferior subluxation of the humeral head is frequently experienced immediately after osteosynthesis for proximal humerus fractures and occurs in 31–42% of patients at 1–2 weeks after surgery [ 1 , 2 ]. Most cases are transitory and improve with time; however, persistent inferior shoulder subluxation observed 1 year postoperatively is associated with screw articular surface perforation and low Constant score [ 3 ]. Therefore, it is important to identify the risk factors of postoperative subluxation and investigate its postoperative course.…”

Section: Introductionmentioning

confidence: 99%

Inferior subluxation of humeral head after osteosynthesis for greater tuberosity fracture

et al. 2022

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Background Inferior subluxation of the humeral head is frequently observed immediately after surgery for proximal humerus fractures; however, the incidence and risk factors of inferior subluxation after osteosynthesis for isolated greater tuberosity fractures remain unsolved. Additionally, the postoperative course of inferior subluxation has not been elucidated. The purpose of the present study is to identify the predictors for the occurrence of postoperative inferior subluxation by multivariate analysis and investigate the postoperative shift of inferior subluxation and its effect on surgical outcomes. Methods We retrospectively identified 68 patients who underwent surgery for isolated greater tuberosity fractures. The dependent variable was the inferior subluxation at 1 week postoperatively. The explanatory variables were age, sex, affected side of the shoulder, body mass index, history of smoking, local osteoporosis, time period to surgery, axillary nerve injury, inferior subluxation before surgery, fracture dislocation, surgical approach, surgical method, operative time, amount of blood loss, and postoperative drainage. Baseline variables that were statistically significant in the univariate analyses were included in the logistic regression analysis. The patients were further categorized into two groups according to the presence of inferior shoulder subluxation exhibited 1 week postoperatively: patients with inferior subluxation (+ IS group) and patients without inferior subluxation (− IS group). We compared the incidence of postoperative complications between the two groups. Results Of 68 patients, 17 (25.0%) had inferior shoulder subluxation observed 1 week postoperatively. Multivariate analysis showed that long operative time was a risk factor for postoperative subluxation (odds ratio = 1.03; P = 0.030). In all cases, inferior subluxation disappeared within 3 months of surgery. No significant difference in complication rate was observed between the + IS and − IS groups. Conclusions The present study provides novel information regarding postoperative inferior subluxation of fractures of the greater tuberosity. Inferior subluxation occurred in 25% of patients immediately after surgery. Long operative time contributes to the onset of postoperative inferior subluxation; however, this was temporary in all cases and had no significant effect on the surgical outcomes. Level of Evidence: Level III.

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Humeral head inferior subluxation in proximal humerus fractures

Abstract: Level III, observational study.

Cited by 8 publications

References 13 publications

Radiographic pseudosubluxation of the shoulder in pediatric proximal humeral fractures

Radiographic pseudosubluxation of the shoulder in pediatric proximal humeral fractures

Incidence and risk factors for pseudosubluxation of the humeral head following proximal humerus fracture

Inferior subluxation of humeral head after osteosynthesis for greater tuberosity fracture

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