Operative Treatment of Severe Proximal Humeral Fractures

Paavolainen, Pekka; Björkenheim, Jan-Magnus; Slätis, P; Paukku, Perth

doi:10.3109/17453678308996587

Cited by 205 publications

(91 citation statements)

References 5 publications

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“…26 Paavolainen et al studied 41 patients in their series and they concluded that displaced fractures of the proximal humerus treated with open reduction and internal fixation gave good results in 74% of cases. 27 In our study based on Neer's functional scoring system, 18 patients had an excellent result while satisfactory results were seen in 10 patients and 2 patients had a poor result which was comparable with that of other studies. The results of surgical management were better in Neer's 2 part fractures as compared to 3 and 4 part fractures.…”

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confidence: 79%

An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

et al. 2017

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Background: Fractures of the proximal humerus are complex injuries associated with significant morbidity. Various options are available for management including non-operative treatment, depending upon the pattern of the fracture, quality of the bone and the surgeon's familiarity with the techniques. The age of the patient, physical activity and the medical fitness also largely influence the treatment options. The aim of this study was to evaluate the functional outcome following surgical management of these fractures and to compare the results with studies as available in literature.Methods: 30 patients with fractures of the proximal humerus managed by surgical means were studied from January 2012 to January 2014 and were followed up for a minimum period of two years.Results: All the fractures treated united clinically by 8 weeks and radiologically by 16 weeks. There were no cases of delayed or non-union in our series. The fractures were more common in men with a gender distribution of 1.3:1 and were also more common in the age group of 50 to 65 years (53%). As per the Neer’s scoring system, 60% patients had excellent results while 33% patients had satisfactory results. They were all pain free and successfully returned to their pre-injury work. 6% patients had an unsatisfactory result. Conclusions: Surgical management of proximal humerus fractures following the principles of articular surface reconstruction, restoration of the anatomy, stable fixation, with minimal injury to the soft tissues and early mobilization, gives good functional results.

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confidence: 79%

An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

et al. 2017

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“…At final followup, the average humeral neck-shaft angle was 130.4° (range, 111°−139°). When the neck-shaft angles were classified based on the method by Paavolainen et al, 13) 54 patients had a score of 'excellent', 2 patients 'good', and none 'poor'. The postoperative humeral neck-shaft angle was on average 6.2° (range, 1°−19°) different relative to the unaffected contralateral shoulder.…”

Section: Resultsmentioning

confidence: 99%

“…The neck-shaft angle was graded radiographically according to Paavolainen et al's method as "good" (121°−140°), "fair" (100°−120°), or "poor" (less than 100°). 13) Further, the accuracy of anatomical reduction was assessed by confirming whether the medial side of the fracture achieved anatomical reduction. The degree of post-operative loss of reduction was measured by comparing the humeral neck-shaft angles and the humeral head height at immediate postoperative and at final follow-up on anteroposterior radiographs (Fig.…”

Section: Assessment Of Clinical Outcomesmentioning

confidence: 99%

The Analysis of the Treatment Outcomes of Proximal Humeral Fractures with Locking Plates

Lee¹,

Hwang²,

Kim³

et al. 2014

Clin Shoulder Elbow

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Background: The aim of this study was to assess the clinical outcomes after treatment of proximal humeral fractures with locking plates, and to determine which factors influence the clinical and radiological outcomes. Methods: Fifty six patients who were treated with locking plates for proximal humeral fractures and had been followed for more than 1 year were enrolled in this study. We performed functional evaluation using the Constant score and analyzed radiographic results. The following factors that may potentially influence the clinical outcomes were assessed: age, gender, type of fracture, presence of medial metaphyseal comminution, bone mineral density, anatomical reduction, restoration of medial mechanical support, and postoperative complications. Results: The mean Constant score was 70.1 points at the final follow-up. Female gender, 4-part fractures, AO type-C fractures, and fractures with medial metaphyseal comminution were associated with a poor clinical outcome. On the other hand, restoration of medial mechanical support and accurate anatomical reduction had a positive influence on clinical outcomes. Postoperative complications resulted in 3 patients (intra-articular screw perforation: 1 patient, varus deformity with screw loosening: 1 patient, nonunion: 1 patient). Conclusions: When treating proximal humeral fractures with locking plate fixation, following factors: a female gender, Neer type 4-part fracture, AO type C fracture, and medial metaphyseal comminution are important risk factors that surgeons should take into consideration. Factors that contribute to better clinical outcomes of operative treatment for humeral fractures are accurate anatomical reduction and restoration of medial mechanical support. (Clin Shoulder

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“…The results reported by Neer (1970b) have not been convincingly confirmed by others. Using the Neer assessment key, closed, as well as open, reduction and internal fixation seems to yield 50-60 per cent reported by Paavolainen et al (1983) and Stableforth (1984).…”

Section: Discussionmentioning

confidence: 99%

Proximal humeral fractures: Late results in relation to classification and treatment

Kristiansen

Christensen

1987

Acta Orthopaedica Scandinavica

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Operative Treatment of Severe Proximal Humeral Fractures

Cited by 205 publications

References 5 publications

An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

The Analysis of the Treatment Outcomes of Proximal Humeral Fractures with Locking Plates

Proximal humeral fractures: Late results in relation to classification and treatment

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