Results of open reduction and internal fixation of severe fractures of the proximal humerus in elderly patients

Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; Silva, Luciana Andrade da; Sella, Guilherme do Val; Filho, João Manoel Fonseca; Ferreira, Marco Tonding; Filho, Paulo Roberto Davanso; Checchia, Sérgio Luiz

doi:10.1016/j.rboe.2014.01.002

Cited by 5 publications

(5 citation statements)

References 25 publications

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“…Most patients in our study had open reduction and internal fixation procedures performed for both fractures. This is consistent with the findings of prior research, which found that open reduction and internal fixation is the most effective treatment technique for fractures of this kind (Miyazaki et al, 2014;Yuan et al, 2021). Closed reduction, internal fixation, and external fixation were other therapeutic methods.…”

Section: Resultssupporting

confidence: 92%

Frequency of Ipsilateral Femoral Neck Fractures in Patients With Femoral Shaft Fractures

KHAN,

TAREEN,

JUNAID

2023

Biol Clin Sci Res J

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Young people are regularly injured and get femoral shaft fractures. Comprehensive data is needed to determine the frequency of ipsilateral femoral neck fractures in people with femoral shaft fractures. In the present study, individuals with femoral shaft fractures will be examined to determine the frequency of ipsilateral femoral neck fractures. A retrospective study was conducted at the Department of Orthopedic Surgery, Combined Military Hospital (CMH) Rawalpindi, from January 2023 to August 2023. There were 160 participants in the research who had femoral shaft fractures. Preoperative radiographs and intraoperative results were examined to determine if the patients had ipsilateral femoral neck fractures. This retrospective study covered 160 femoral shaft fracture patients with averaged 35 years old, with 75% being male and 25% female. Road traffic accidents (62.5%), falls from height (25%) and sports injuries (3.75%) caused the greatest injuries. 8(5%) had ipsilateral femoral neck fractures. Patients with ipsilateral femoral neck fractures were 35 years old and were 75% male. 87.5% of patients had good surgical results, 6.3% fair, and 6.3% poor. The most frequent consequences were non-union (3.1%), malunion (1.3%), and infection (1.9%). This study identified 5% of ipsilateral femoral neck fractures in femoral shaft fracture patients. These patients must be carefully evaluated and managed to minimize missing or delayed identification of concomitant femoral neck fractures. There were 5% ipsilateral femoral neck fractures in femoral shaft fracture patients. These patients must be carefully evaluated and managed to minimize missing or delayed identification of concomitant femoral neck fractures. Early detection and treatment of these fractures may improve results and avoid complications.

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Section: Resultssupporting

confidence: 92%

Frequency of Ipsilateral Femoral Neck Fractures in Patients With Femoral Shaft Fractures

KHAN,

TAREEN,

JUNAID

2023

Biol Clin Sci Res J

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“…The Constant-Murley score for the contralateral side was 82.6%, consistent with other studies on nonoperative treatment, 8 11 12 13 14 as well as with the surgical treatment using arthroplasty or locked plate fixation. 17 18 19 20 Subjective scores (i.e., ASES and SANE) were similar to those reported in systematic reviews. 2 Our results reinforce findings from the Proximal Fracture of the Humerus Evaluation by Randomization (PROFHER) study and a Cochrane systematic review demonstrating that nonoperative treatment can provide good functional outcomes even in deviated fractures.…”

Section: Discussionsupporting

confidence: 78%

“…Obtivemos resultados da escala de Constant-Murley relativa ao lado contralateral de 82,6%, valores semelhantes aos de outros estudos sobre tratamento não operatório, 8 11 12 13 14 assim como os obtidos no tratamento cirúrgico com artroplastia ou com a fixação com placa bloqueada. 17 18 19 20 Nas escalas subjetivas, ASES e SANE, obtivemos valores semelhantes ao demonstrado nas revisões sistemáticas. 2 Nossos resultados reforçam os achados do estudo Proximal Fracture of the Humerus Evaluation by Randomization (PROFHER) e da revisão sistemática Cochrane, demonstrando que o tratamento não operatório, mesmo em fraturas desviadas, pode trazer bons resultados funcionais.…”

Section: Discussionunclassified

Tratamento não operatório de fraturas desviadas da extremidade proximal do úmero em idosos: Correlação entre os desvios e os resultados clínicos

Gracitelli

Yamamoto

Malavolta

et al. 2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivos Descrever o resultado funcional do tratamento não operatório de fraturas desviadas da extremidade proximal do úmero (FEPU) pela escala da American Shoulder and Elbow Surgeons (ASES, na sigla em inglês) após 12 meses e avaliar se as diferentes classificações e medidas radiográficas iniciais têm correlação com os resultados clínicos. Métodos Foram avaliados em tempos padronizados (3, 6 e 12 meses), 40 pacientes > 60 anos com FEPU submetidos ao tratamento não operatório. Foram utilizadas as escalas da ASES, Constant-Murley e Single Assessment Numeric Evaluation (SANE, na sigla em inglês). As variáveis radiográficas incluíram as classificações de Neer e Resch, a presença de fratura e desvio dos tubérculos, cominuição metafisária, lesão periosteal medial, desvios angulares e translacionais da cabeça no plano coronal e sagital e desvio dos tubérculos. Resultados Observamos resultados pela escala de ASES de 77,7 ± 23,2 para toda a amostra, pela de Constant-Murley de 68,7 ± 16 e de 82,6% para a escala em relação ao lado contralateral. A escala de SANE aos 12 meses foi de 84,8 ± 19. Os critérios radiográficos que apresentaram influência negativa no resultado clínico pela escala de ASES aos 12 meses foram a gravidade pela classificação de Neer e pelo desvio angular no plano coronal (mensurado pelo ângulo cabeça-diáfise) e a presença de fratura dos tubérculos. Conclusão O tratamento não operatório de fraturas desviadas da extremidade proximal do úmero em pacientes idosos resulta em bons resultados clínicos. Os resultados clínicos são influenciados negativamente pelo desvio angular da cabeça do úmero e pela presença de fratura dos tubérculos maior e menor, assim como pela classificação de Neer.

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“…We reviewed various articles and found that many of the articles mentioning severe PHF were based on the Neer classification. 37 - 40 Many 1- or 2-part fractures were treated conservatively. Even with surgical treatment, fixation is easy and robust.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Severe Proximal Humerus Fracture and Correlation Between Deltoid Tuberosity Index and Bone Mineral Density

Kim

Park

Kim

et al. 2020

Geriatr Orthop Surg Rehabil

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Introduction: The aims of this study were to investigate (1) whether demographic factors would be risk factors for severe proximal humerus fracture (PHF), (2) relationship of radiological parameters with bone mineral density (BMD), deltoid tuberosity index (DTI), or severe PHF, and (3) correlation between DTI and BMD. Methods: We conducted a cross-sectional study based on radiographs and medical records taken during admission or the visit to the orthopedic clinic. We reviewed consecutive 100 adult patients who were diagnosed with PHF in our hospital from March 2014 to December 2016. Three- and 4-part fractures were regarded as severe PHFs. Univariable and multivariable logistic regression analyses were performed to evaluate risk factors for severe PHF. Also, we investigated the correlation between BMD and DTI using the additional BMD data of the patients who underwent shoulder surgeries. Results: This study included 62 nonsevere PHFs and 38 severe PHFs. There were 30 male and 70 female patients with a mean age of 66.4 ± 16.4 years. Mean T score of BMD was −2.5 ± 0.9 at the time of injury. Logistic regression analyses showed that age (odds ratio: 1.044, range: 1.011-1.079, P = .009) and sex (odds ratio of females: 3.763, range: 1.236-11.459, P = .020) were related to severe PHF. The group satisfying the radiological parameter criteria had significantly higher rates of severe PHF. The correlation coefficient (r) between DTI and T score was 0.555 ( P < .001). Discussion and Conclusion: Older age and female were the independent risk factors for severe PHF. Conversely, BMD and other medical comorbidities were not risk factors for severe PHF. Deltoid tuberosity index showed significantly high intraclass correlation coefficient and a strong correlation with the T score of BMD. Therefore, DTI may be useful for screening osteoporosis in PHF patients. Level of Evidence: Level IV, Cross-sectional study.

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Results of open reduction and internal fixation of severe fractures of the proximal humerus in elderly patients

Cited by 5 publications

References 25 publications

Frequency of Ipsilateral Femoral Neck Fractures in Patients With Femoral Shaft Fractures

Frequency of Ipsilateral Femoral Neck Fractures in Patients With Femoral Shaft Fractures

Tratamento não operatório de fraturas desviadas da extremidade proximal do úmero em idosos: Correlação entre os desvios e os resultados clínicos

Risk Factors for Severe Proximal Humerus Fracture and Correlation Between Deltoid Tuberosity Index and Bone Mineral Density

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