Intermediate Outcomes Following Percutaneous Fixation of Proximal Humeral Fractures

Abstract

"Intermediate outcomes following percutaneous fixation of proximal humeral fractures." The Journal of Bone and Joint Surgery.94,13. 1223-1228. (2012

Post-traumatic osteonecrosis of the proximal humerus

“…They demonstrated that the rate of radiographically evident osteonecrosis more than doubled from 8% at 12 months to 19% at a mean 45 month final follow-up. This finding was independently supported in a multicentre evaluation of a similar group of patients followed up to a mean 84 months [25]. Twenty-six percent of patients were diagnosed with posttraumatic osteonecrosis at a mean of 50 months after surgery; however over half (57%) were identified more than two years after fixation with no clinical or radiographic findings to suggest pathology up to that point.…”

Proximal humerus fractures

“…Generally, results following this method of treatment are satisfactory, especially with two-and three-part proximal humeral fractures (Keener et al, 2007;Harrison et al, 2012). Studies demonstrate that functional outcome is related to overall alignment (Calvo et al, 2007).…”

“…Additionally, osteonecrosis rates may be lower, although a recent intermediate outcome study demonstrated a 28% rate of osteonecrosis following surgery (Harrison et al, 2012). Surgery typically results in less blood loss, lower perioperative morbidity, less cost, and, theoretically, less scarring.…”

Evaluation and Management of Proximal Humerus Fractures

“…Reported complications of this technique include pin track infections, avascular necrosis of the humeral head, and pin migration with resultant loss of reduction [24]. Longer term followup of patients treated with percutaneous fixation revealed greater prevalence of osteonecrosis and posttraumatic osteoarthritis than previously reported [28]. …”