Percutaneous fixation with Schanz screws for displaced two- and three- part fractures of the proximal humerus in patients above fifty years of age

Eid, Abdelsalam; Osman, M.A.; Fekry, Hosam-Eldeen

doi:10.4103/0973-6042.83195

Cited by 6 publications

(6 citation statements)

References 16 publications

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“…However, many complications were related to incorrect surgical techniques and, therefore, could be avoided. 23,25,26 The results pertaining to functional outcomes after 2 years in the hemiarthroplasty group (DASH score, 9.2; Constant score, 78.4) are comparable with those in the ORIF group (DASH score, 15.3; Constant score, 65.1).…”

Section: Discussionmentioning

confidence: 77%

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Internal Fixation Versus Shoulder Hemiarthroplasty for Displaced 4-part Proximal Humeral Fractures in Elderly Patients

Cai

Tao²,

Yang³

et al. 2012

Orthopedics

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The purpose of this single-center, randomized, controlled trial was to report on the 2-year outcomes of proximal humerus fractures in elderly patients treated with open reduction and internal fixation (ORIF) with either a locking plate or shoulder hemiarthroplasty. Thirty-two patients (87% women) with a mean age of 71.9 years (range, 67-86 years) were treated with ORIF with either a locking plate or shoulder hemiarthroplasty after shoulder injury. The main outcome measures were the Constant score, Disabilities of the Arm, Shoulder and Hand (DASH) score, and health-related quality of life (HRQoL) according to the EQ-5D (EuroQol Group, Rotterdam, The Netherlands). At final 2-year follow-up, DASH and pain scores favored the shoulder hemiarthroplasty group. Mean flexion was 129° in the shoulder hemiarthroplasty group and 117° in the ORIF group (P=.27), and mean abduction was 123° in the shoulder hemiarthroplasty group and 111° in the ORIF group (P=.41). In the shoulder hemiarthroplasty group, the EQ-5D index score decreased from 0.85±0.21 before injury to 0.65±0.14 at 4 months postoperatively. The score was 0.79±0.24 at 12 months postoperatively and 0.81±0.17 at 24 months postoperatively. The results of this study indicate an advantage in functional outcomes and HRQoL favoring shoulder hemiarthroplasty compared with ORIF with a locking plate, although most outcomes were not significantly different.

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Section: Discussionmentioning

confidence: 77%

“…The normal population values depend on age, sex, and activity level of the patient. The best possible score is 100 and includes an as-sessment of shoulder function in 4 dimensions: pain (15), activities of daily living (20), range of motion (40), and strength (25).…”

Section: Primary Assessment and Follow-upmentioning

confidence: 99%

Internal Fixation Versus Shoulder Hemiarthroplasty for Displaced 4-part Proximal Humeral Fractures in Elderly Patients

Cai

Tao²,

Yang³

et al. 2012

Orthopedics

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“…Nonthreaded wires can be used to manipulate the fracture site prior to fixation with threaded wires. Specific techniques are described for valgus angulated fractures by Seyhan et al 34 and varus angulated fractures by Eid et al 35 Although technically demanding, the results are excellent with Constant-Murley scores of 90 to 94 at 1 to 3 years of follow-up.…”

Section: Managementmentioning

confidence: 99%

Proximal Humerus Fractures: Evaluation and Management in the Elderly Patient

Schumaier

Grawe

2018

Geriatr Orthop Surg Rehabil

152

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Introduction:Proximal humerus fractures are common in the elderly. The evaluation and management of these injuries is often controversial. The purpose of this study is to review recent evidence and provide updated recommendations for treating proximal humerus fractures in the elderly.Methods:A literature review of peer-reviewed publications related to the evaluation and management of proximal humerus fractures in the elderly was performed. There was a focus on randomized controlled trials and systematic reviews published within the last 5 years.Results:The incidence of proximal humerus fractures is increasing. It is a common osteoporotic fracture. Bone density is a predictor of reduction quality and can be readily assessed with anteroposterior views of the shoulder. Social independence is a predictor of outcome, whereas age is not. Many fractures are minimally displaced and respond acceptably to nonoperative management. Displaced and severe fractures are most frequently treated operatively with intramedullary nails, locking plates, percutaneous techniques, or arthroplasty.Discussion:Evidence from randomized controlled trials and systematic reviews is insufficient to recommend a treatment; however, most techniques have acceptable or good outcomes. Evaluation should include an assessment of the patient’s bone quality, social independence, and surgical risk factors. With internal fixation, special attention should be paid to medial comminution, varus angulation, and restoration of the calcar. With arthroplasty, attention should be paid to anatomic restoration of the tuberosities and proper placement of the prosthesis.Conclusion:A majority of minimally displaced fractures can be treated conservatively with early physical therapy. Treatment for displaced fractures should consider the patient’s level of independence, bone quality, and surgical risk factors. Fixation with percutaneous techniques, intramedullary nails, locking plates, and arthroplasty are all acceptable treatment options. There is no clear evidence-based treatment of choice, and the surgeon should consider their comfort level with various procedures during the decision-making process.

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“…8 Furthermore, a case series that looked at 27 patients undergoing K-wire fixation in 2-and 3-part fractures and fixed with percutaneous screws showed excellent results with a mean Constant score of 89.9 at 1e3 year follow up. 12 Another emergent technique is the use of metal humeral block screwed into the lateral humeral cortex to secure wires threaded into the head at 35 to the shaft and 25 to each other. Screws can be added to secure other fragments if necessary.…”

Section: Percutaneous Kirschner Wire (K-wire)mentioning

confidence: 99%

Outcomes following fixation for proximal humeral fractures

Antonios

Bakti

Nzeako

et al. 2019

Journal of Clinical Orthopaedics and Trauma

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Fractures of the proximal humerus are a very common presentation in modern Trauma and Orthopaedic practice. In an ever-aging population, the incidence has dramatically increased resulting in a large socioeconomical burden. The surgical management of these injuries has evolved over the years. Patient outcomes are variable and there is no consensus on treatment approach. This review article focuses on the outcomes following fracture fixation using common surgical techniques.

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Percutaneous fixation with Schanz screws for displaced two- and three- part fractures of the proximal humerus in patients above fifty years of age

Cited by 6 publications

References 16 publications

Internal Fixation Versus Shoulder Hemiarthroplasty for Displaced 4-part Proximal Humeral Fractures in Elderly Patients

Internal Fixation Versus Shoulder Hemiarthroplasty for Displaced 4-part Proximal Humeral Fractures in Elderly Patients

Proximal Humerus Fractures: Evaluation and Management in the Elderly Patient

Outcomes following fixation for proximal humeral fractures

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