Neer arthroplasty for humeral fracture

Willems, W.J.H.; Lim, Thou

doi:10.3109/17453678508994355

Cited by 51 publications

(17 citation statements)

References 6 publications

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“…Despite being the established surgical procedure for 3-and 4-part fracture patterns, the long-term results have been mixed. Whereas Neer 24,26 reported excellent outcomes for both range of motion and pain relief, numerous other studies have reported suboptimal or poor results for proximal humeral fractures treated with hemiarthroplasty, 5,11,[15][16][17]19,29,30,32 Inferior long-term outcomes in the elderly are especially noteworthy. 29 In our study of 47 patients treated with hemiarthroplasty for acute 3-and 4-part proximal humeral fractures, we found a decline in functional ability as measured with 4 measures (UCLA scale, ASES index, SST-12, and Constant shoulder test); an increase in pain and an increase in patients with arthritis, tuberosity reabsorption, and stem osteolysis; a decrease in AHD; and no improvement on physical examination tests.…”

Section: Discussionmentioning

confidence: 93%

Functional and radiographic long-term outcomes of hemiarthroplasty for proximal humeral fractures

Noyes¹,

Kleinhenz²,

Markert³

et al. 2011

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 93%

Functional and radiographic long-term outcomes of hemiarthroplasty for proximal humeral fractures

Noyes¹,

Kleinhenz²,

Markert³

et al. 2011

Journal of Shoulder and Elbow Surgery

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“…There have also been many reports about this non-constrained type. Most of these reports [4,29] have shown marked pain relief at resting or during exercise and satisfactory shoulder function as a whole, but do not always satisfied with their range of motion in the shoulder [ 15,36,42].…”

Section: Discussionmentioning

confidence: 99%

The radiographic study in the relationship of the glenohumeral joint

Takase¹,

Yamamoto²,

Imakiire³

et al. 2004

Journal Orthopaedic Research

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Accurate reproduction of anatomic relationship is important in non‐constrained prosthetic arthroplasty. The accurate lateral glenohumeral offset, which indicates a parameter of the lever arm of the deltoid and supraspinatus muscles, is one of the most important elements in achieving the efficient shoulder functions after prosthetic reconstruction. However, to our knowledge, there has been no detailed study on the influence of minute changes in the neck shaft angle, within the normal range, on lateral glenohumeral offset. In this study, we evaluated the relationship between the neck shaft angle and various geometric measurement values in the glenohumeral joint. Radiographs of 471 shoulders without osseous lesions in the glenohumeral joint and greater tuberosity were reviewed. There were 265 males and 206 females, and a mean age was 53.5 years old. The final diagnosis was impingement syndrome in 269 patients, rotator cuff tear in 147, and control group in 55 patients. Eight parameters were measured on true anteroposterior radiographs. The lateral glenohumeral offset correlated with the radius of the curvature of the humeral head and the humeral head diameter. The neck shaft angle was not correlated with the offset value. However, when the offset value was divided by the humeral head diameter, to eliminate the affection of the size of the humeral head toward the offset, a correlation was observed with the neck shaft angle. Based on these correlations, we could obtain the equation of the lateral glenohumeral offset according to the neck shaft angle. Using the equation, when the neck shaft angle is decided, the lateral glenohumeral offset can be estimated based on the correlation between the parameters, which achieve the efficient shoulder functions after prosthetic components. Therefore, inaccurate determination of the neck shaft angle in the humeral head component design and selection may induce dysfunction of the abductor muscles. © 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.

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“…The patients in our study were heavy workers and/or labourers and their outcome would be disproportionate due to undue loads placed on shoulder region. Twenty nine (74.35%) of these injuries in our series were due to high-energy trauma sustained, compared to the other studies where almost 89% caused by moderate trauma and 93% following trivial trauma involving activities of daily living, thus giving a higher proportion of osteoporotic fractures around shoulder [4,15]. Our patients had a mean radiological union time of 12 weeks, as compared to 15.2 weeks (3.8 months) in studies where open reduction along with internal fixation or a combination of internal and external fixation was employed [16].…”

Section: Discussionmentioning

confidence: 42%

“…The widely accepted treatment of severely comminuted intra-articular proximal humeral fractures is hemi-arthroplasty or total shoulder arthroplasty [6,7]. Several surgical treatment options, such as closed reduction and percutaneous fixation [8], open reduction and internal fixation with a variety of constructs [9][10][11][12][13], proximal humeral intra medullary nailing [14] and shoulder arthroplasty [15], have been used with relatively good outcomes.…”

Section: Introductionmentioning

confidence: 99%

Complex Proximal Humeral Fractures (Three or Four Part) with Dislocation: Outcome Analysis of Percutaneous Reduction and External Fixation

Nikose¹

2016

MOJOR

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Background: The complex fractures of the proximal humerus remain dilemmas far as treatment is concerned. Although better-quality techniques of internal fixation and prosthetic replacement are introduced effectively in the field of operative fracture care, management of complex fractures of the proximal humerus for head preserving modalities in injuries involving the humeral head remains to be a major factor concerning the trauma surgeon. Materials & Methods:Thirty nine patients with complex three or four part proximal fracture of humerus with dislocation of humeral head were treated and analyzed for results of percutaneous reduction and external fixation. All Patients were subjected to careful closed reduction under general anesthesia with optimal relaxation and fluoroscopic control followed by percutaneous external fixation of proximal humerus in optimal position. The patients were evaluated clinically and radiologically for a period till union or 10 months, whichever was earlier.One patient had an incomplete brachial plexus injury, which was yet to recover completely at the end of last follow up 10 months, with acceptable hand, elbow and shoulder function.Results: Percutaneous reduction & external fixation to treat complex fractures of the proximal humerus produces good results, if correct re-position and biological principles are respected. Most of the patients were pain-free and the shoulders functioned well despite the severity of shoulder injury. Conclusions:Percutaneous reduction and external fixation is a reasonable and logical approach to treat complex proximal humeral head fractures, rather than conservative treatment and before hemi-arthroplasty by prosthesis is considered, in view of the acceptable results obtained. Our study shows that complex fractures of the proximal humerus should be treated initially by head preserving procedures. The probable revascularization of the humeral head occurs by creeping substitution as the shoulder is non weight bearing joint.

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Neer arthroplasty for humeral fracture

Cited by 51 publications

References 6 publications

Functional and radiographic long-term outcomes of hemiarthroplasty for proximal humeral fractures

Functional and radiographic long-term outcomes of hemiarthroplasty for proximal humeral fractures

The radiographic study in the relationship of the glenohumeral joint

Complex Proximal Humeral Fractures (Three or Four Part) with Dislocation: Outcome Analysis of Percutaneous Reduction and External Fixation

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