PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “SHOULDER FRACTURES”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMedDate not supplied

Posterior shoulder dislocation with ipsilateral humeral shaft fracture. A case report.

A 41-year-old man incurred the unusual combination of subacromial posterior dislocation of the shoulder and ipsilateral humeral shaft fracture. The importance of inspection of joints proximal to long bone fractures cannot be overemphasized. The transscapular view is easily adapted to the diagnosis of this injury. When recognized early, closed reduction is the preferred treatment; open reduction, as in the present case, is reserved for chronic dislocation.

Adult↗
PubMed1990

[Proximal bilateral humeral fractures with posterior dislocation of the head of the humerus].

Seizures as the cause of skeletal fractures are well recognized. The commonest is fracture of the humerus. Bilateral fractures are rare and extremely rare in combination with posterior dislocation of the shoulder joint. Two cases of this condition with very unusual etiology are described here. The mechanism of the injury is described and the treatment discussed. Regardless of the method of primary reposition employed, no difference in the subsequent joint function appears to be observed. Nevertheless, recognition of the condition and early reduction are of importance for the result.

Brain Abscess↗
PubMedDate not supplied

Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus.

The purpose of this multicenter study was to analyze the results of shoulder arthroplasty for the treatment of the sequelae of proximal humerus fractures and establish an updated classification system and treatment guidelines for these complex situations. Seventy-one sequelae of proximal humerus fractures were treated with shoulder replacement with the use of the same nonconstrained, modular, and adaptable prosthesis: the Aequalis prosthesis (Tornier Inc, St Ismier, France). The average time between initial fracture and shoulder arthroplasty was 5 years and 5 months. On the basis of anatomic classification schemes, sequelae were divided into 4 types: type 1, humeral head collapse or necrosis with minimal tuberosity malunion (40 cases); type 2, locked dislocations or fracture-dislocations (9 cases); type 3, nonunions of the surgical neck (6 cases); and type 4, severe malunions of the tuberosities (16 cases). The mean postoperative follow-up was 19 months (range, 12 to 48 months). Overall, the postoperative Constant score was excellent in 11 cases (16%), good in 19 cases (26%), fair in 18 cases (25%), and poor in 23 cases (33%). There were 18 complications (27%). Fifty-nine of 70 patients (81%) stated that they were satisfied with the result. The most significant factor affecting functional outcome was greater tuberosity osteotomy (P <.005). Regarding both surgical treatment and postoperative prognosis, we identify 2 categories of proximal humerus fracture sequelae: category 1, intracapsular/impacted fractures sequelae (associated with both cephalic collapse or necrosis [type 1] and chronic dislocation or fracture-dislocation [type 2]), in which an articulating joint can be reconstructed without a greater tuberosity osteotomy; and category 2, extracapsular/disimpacted fractures sequelae (associated with both surgical neck nonunions [type 3] and severe tuberosity malunions [type 4]) where the proximal humerus cannot be reconstructed without a greater tuberosity osteotomy. All of the excellent and good postoperative Constant scores were obtained in type 1 and 2, in which osteotomy of the greater tuberosity was not required. All patients in type 3 and 4, who underwent a greater tuberosity osteotomy, had either fair or poor results and did not regain active elevation above 90 degrees. We conclude that a greater tuberosity osteotomy is the most likely reason for poor and unpredictable results after shoulder replacement arthroplasty for the treatment of the complex sequelae of proximal humerus fractures. Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus should be performed without an osteotomy of the greater tuberosity when possible. If prosthetic replacement is possible without an osteotomy, surgeons should accept the distorted anatomy of the proximal humerus and adapt the prosthesis and their technique to the modified anatomy. A modular and adaptable prosthesis with both adjustable offsets and inclination may allow surgeons to adapt to a large number of malunions and may help to avoid the troublesome greater tuberosity osteotomy in a higher proportion of cases.

Adult↗
PubMed1988

Orthopedic pitfalls in emergency medicine.

Acute orthopedic problems make up a large part of everyday emergency department practice. Misdiagnosis of these injuries often results from failure to consider certain clinical entities as a cause of the patient's complaints, and may result in unnecessary complications for the patient. Indeed, missed orthopedic injuries are the leading cause of malpractice claims in emergency medicine. The orthopedic injuries that most notoriously escape detection by the primary care physician are closed tendon injuries of the hand, carpal bone injuries, occult fractures about the elbow, femoral neck fractures, posterior dislocation of the shoulder, epiphyseal plate injuries, fractures of the pubic ramus, patellar tendon rupture, Lisfranc injuries, compartment syndromes, and multiple injuries. If the physician is unaware of these entities when evaluating the patient, he will not make the diagnosis. This review is designed to heighten the primary care physician's awareness of these injuries, which are a common source of problems in the emergency department.

Aged↗
PubMed1980

[Indications and technique of osteosynthesis in dislocated fractures of the humeral head in adults (author's transl)].

Fractures of the proximal end of the humerus are treated by early functional movement. Dislocated fractures of the humeral head should be treated by means of osteosynthesis. In younger patients osteosynthesis with a T- or L-shaped plate is the method of choice; in older patients, open reduction and K-wire fixations can be used. Indications for screw osteosynthesis are rare, and alloarthroplasty is a procedure reserved for exceptions. The functional results are demonstrated by 24 cases with dislocated fractures who were operated on, thus showing the principles of operative treatment.

Adult↗
PubMed2001

[Osteosynthesis techniques in proximal humeral fractures].

Although proximal humeral fractures are common injuries, there is no generally accepted strategy as to how unstable and displaced two- to four-part fractures should be managed. Surgical therapy is in a conflicting situation between the requirement for anatomical fracture reduction and stable fixation, on the one hand, and the necessity for minimal intraoperative damage to the soft tissue and arterial vascularization of the humeral head in order to avoid avascular necrosis on the other. Whereas minimally invasive procedures using closed or percutaneous reduction and fixation techniques are advantageous for protection of the arterial blood supply of the proximal humerus, plate fixation provides superior fixation stability. Plate fixation seems to be associated with a reduced risk of avascular necrosis when indirect reduction techniques are used. Poor results in the operative management of humeral head fractures are often seen in association with malunion. There is therefore a tendency towards the use of implants with angular stability in order to reduce the risk for secondary loss of reduction during functional after treatment. Innovative new plates and intramedullary nails that provide superior stability of fixation of the humeral head fragment have been actually introduced into clinical practice. Together with the specific patient and fracture characteristics, the final result of operative management, however, remains mainly related to the knowledge and operative skills of the trauma or orthopaedic surgeon who deals with these proximal humeral fractures.

Bone Plates↗
PubMed2005

[Thoracic inlet syndrome after ESIN of comminuted clavicular fracture].

Thoracic inlet syndrome is a rare venous obstruction of the upper extremity caused by narrowness of the costoclavicular angle. This case report describes an obstruction of the vena subclavia after percutaneous elastic stable medullary nailing of a comminuted fracture of the clavicle.

Bone Nails↗
PubMed1973

Missed fractures.

Explore the source record for details and available documents.

Accidents↗
PubMed1987

Neurovascular injury complicating displaced proximal fractures of the humerus.

Three cases with injury of the axillary artery and brachial plexus complicating a displaced proximal fracture of the humerus are presented. In two patients the arterial injury was not recognized on admission. Vascular repair had to be carried out in all three cases. Two patients showed a persistent neurological deficit. In two of the cases, the arterial injury may have been caused by an attempt at closed reduction of the fracture. The possibility of axillary arterial injury should be considered in proximal fractures of the humerus with severe medial displacement of the shaft of the humerus.

Aged↗
PubMed1993

The two-part proximal humeral fracture: a review of operative treatment using two techniques.

A review of 45 patients who have undergone surgery for two-part fractures of the proximal humerus (Neer Group III) is reported using two operative techniques, AO plating and intramedullary Rush pins. Good functional results were obtained using the former technique in seven out of eight of the patients under the age of 50 years who mainly sustained their original injury as a result of high-energy motor vehicle accidents. However, in the more common low-energy, osteoporotic fracture in the elderly population, results were unsatisfactory in 12 out of 14 cases where AO plating was used, usually as a result of fixation failure. The Rush pin technique produced more reliable results in this age group, with satisfactory functional scores being obtained in 16 out of 23 patients. It is suggested that the Rush pin technique is preferable to plate fixation in the more common osteoporotic insufficiency fracture in the elderly.

Adult↗
PubMed1994

Blade plate fixation of proximal humeral non-unions.

Non-union of fracture of the proximal humerus is unusual and can be difficult to treat. It is found more often than not in the elderly patient with weak bone, resorption at the fracture site, contracture of the glenohumeral joint and associated medical conditions. A blade plate, designed specifically for the treatment of these non-unions, was used in nine patients--seven females and two males (mean age 66 years)--who had painful non-union with a mean duration of 22.5 months. Autologous bone grafting was used in all cases. Eight non-unions followed displaced two-part proximal humeral fractures: five had been initially treated conservatively and four with medullary nails. Five patients had associated medical illness. After a mean of 6.5 months (range 4-28 months), union had been achieved in all but one patient. Functional evaluation revealed good results in five patients, fair results in three and one poor result. Use of the blade plate offered a successful method of stable internal fixation in these complex cases.

Aged↗