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 1,153 records · Page 64Linked to original sources
PubMed2004

Increased fragility in patients with fracture of the proximal humerus: a case control study.

The aim of this study was to evaluate whether a fracture of the proximal humerus is associated with an increased prevalence of preceding fractures or a risk of subsequent fractures. All patients who were treated at the Malmö General Hospital in 1987 for a fresh fracture of the proximal humerus were identified, representing practically all fractures of the proximal humerus in Malmö city (250,000) that year. Two hundred fifty-three adult patients, 54 men with an average age of 66 (24-90) and 199 women with a mean age of 74 (22-98) years, were included in the study together with 475 age- and gender-matched control persons. In 1999, fracture prevalence of patients and controls were rated by a survey at the Dept. of Radiology. There was a significantly increased prevalence of previous fractures before 1987 in the humerus fracture group with an odds ratio (OR) of 3.5 [95% confidence interval (95% CI), 2.2-5.5] for a spinal fracture, OR 1.8 (95% CI, 1.3-2.6) for a previous fracture to the upper extremity, and OR 1.8 (95% CI, 1.2-2.6) for a preceding fracture of the lower limb. The proximal humerus fracture also predicted a significantly increased risk of a subsequent fracture. The hazard ratio (HR) was 2.5 (95% CI, 1.7-3.7) for a forthcoming spinal fracture, HR 2.8 (95% CI, 2.0-3.7) for a future fracture of the upper extremity, and HR 2.0 (95% CI, 1.2-3.5) for a lower limb fracture. In a subgroup of male patients, an almost five times increased risk of sustaining subsequent extremity fractures was observed. In summary, a fracture of the proximal humerus is associated both with increased prevalence of previous fractures of the spine and extremities and also predicting an increased risk of future fractures.

Adult↗
PubMed1981

The mechanisms producing fracture-separation of the proximal humeral epiphysis.

Six mechanisms which may produce fracture-separation of the proximal humeral epiphysis are proposed. Four of them are illustrated by case reports. It is suggested that they may be differentiated by examination of the patient and study of the radiographs. In unstable fractures manipulation is indicated and, if performed with an understanding of the mechanism of injury, will produce a stable reduction.

Adolescent↗
PubMed1990

Fractures of the proximal humerus in children. Nine-year follow-up of 64 unoperated on cases.

Fracture of the proximal humerus in children is rare. The records from 1976 to 1977 of 77 patients aged 0-15 years with a fracture or epiphyseal separation of the proximal humerus were reviewed. Totally, 64 of 72 patients had a follow-up examination (median observation time 9 years). Twenty-one children had an epiphyseal separation and 51 a metaphyseal fracture. All but 1 were treated conservatively. Seven had slight sequelae at follow-up, i.e., transient pain or minor restriction of motion. The rest were asymptomatic. Full remodeling of fractures left displaced occurred in all the cases. No avascular necrosis or shortening of the humerus were found. Nonoperative treatment is appropriate for proximal humeral fractures in children, even for those with extensive displacement.

Adolescent↗
PubMed1986

A new classification of proximal humeral fractures.

Neer's classification of humeral fractures was proved on 657 patients. This classification enables the radiologist to estimate the risk of avascular necrosis of the head of the humerus. The problematic group is that of four part lesions, which has a 19% incidence of humeral head necrosis. Since in this group minimal osteosynthesis produces better functional results than extensive osteosynthesis, a detailed pre-operative radiological description of the fracture type is necessary in order to spare the patient from extensive surgery which could have unsatisfactory results.

Humans↗
PubMed2005

A new locking plate for unstable fractures of the proximal humerus.

UNLABELLED: In a prospective study, 28 patients with 29 proximal humeral fractures were treated with the Locking Proximal Humerus Plate from 2001-2002. Most of these fractures were complex, Type B (n = 15) and Type C (n = 9) fractures, according to the AO classification. Followups included radiographs, clinical examinations, and recording Constant scores. After 1 year, the average Constant score for all fractures was 74.6 (range, 37-96). For Type A fractures, it was 82.6 (range, 60-96), for Type B it was 78.3 (range, 37-95), and for Type C it was 64.6 (range, 40-91). Complications related to the implant included breakage of the plate in one patient and redislocation of the fracture in four patients (one fracture was associated with deep infection), which required reoperation in two patients. Partial osteonecrosis was seen in two patients, once after deep infection. There were no nonunions. Our data show that using the Locking Proximal Humerus Plate for treatment of proximal humeral fractures of all types is a reliable procedure, with good results being obtained with careful planning and familiarity with the special features of the operative technique. LEVEL OF EVIDENCE: Therapeutic study, Level II-1 (prospective cohort study).

Activities of Daily Living↗
PubMed1992

[Primary humerus head replacement in dislocated proximal humeral fracture. Indications, technique, results].

Displaced three- and four-part fractures of the humeral head detached from their blood supply are at high risk for a poor functional outcome after internal fixation. Primary prosthetic replacement can restore the pretraumatic anatomy, and early function is possible. Head replacement within 2 weeks after trauma, reapproximation of the tuberosities, and reconstruction of the rotator cuff tear establishes early stability and good functional results in up to 80%.

Aged↗
PubMed1989

The epidemiology of fractures of the proximal humerus.

Sevenhundred and thirty proximal humeral fractures, taken from a 5-year period, were entered in this study. We found a higher total incidence rate than that previously seen: 73/100,000 population. Twenty-nine percent of the patients required hospitalization; 75% of these were over 60 years old. Only 21% of these were operated on, the majority of admissions being for social reasons. A total of 583 bed-days were used each year in the Aarhus City area (250,000 inhabitants). The majority of fractures resulted from falls on level ground. The elderly fell at home, while the younger people fell in public areas. Traffic accidents and work accidents were seldom seen. The accidents occurred typically around midday and before midnight, and mostly in December and January. Half of the fractures were two-part fractures of the surgical neck, while fractures of the greater tubercle and three-part fractures accounted for 21% and 17%, respectively. Based on current developments in the population average life span, it can be expected that proximal fractures will increase the hospital workload significantly in the future.

Accidental Falls↗
PubMed2006

[Postoperative CT-controlled results of renewed osteosynthesis using screw fixation for acute scaphoid fractures].

BACKGROUND: Currently screw fixation of the scaphoid is a well-established method to treat unstable scaphoid fractures. PATIENTS AND METHODS: Between June 1995 and December 2000, 68 patients with an unstable acute scaphoid fracture were treated with screw fixation; 46 patients were reexamined on an average 35 months postoperatively. Range of motion and grip strength (Jamar dynamometer) were measured. The total data rating resulted from the Krimmer wrist score. RESULTS: The subjective results were evaluated with the DASH questionnaire. The average postoperative pain score was documented with a visual analogous pain scale from zero to 100 (VAS 0-100). X-rays as well as computed tomography were performed postoperatively. The average range of motion was 124 degrees for extension/flexion (92% of the opposite site), 57 degrees for radial/ulnarduction (=90%), and 177 degrees for pronation/supination (=98%). Postoperative strength was 47 kg (=90% of the opposite site). The postoperative pain score was 13 (0-100) after stress and 2 during resting conditions. Bony consolidation was reached in 44 cases. The Krimmer wrist score demonstrated a very good result in 39 cases, a good result in 5 cases, and a satisfactory result in 3 cases. The average DASH score was 8.3 points. CONCLUSIONS: The results demonstrate the reliability of internal screw fixation as treatment for acute scaphoid fractures. Functional results as well as subjective satisfaction of the patients are very good. Postoperative CT scans help to evaluate exact bony consolidation, position of the screw, and postoperative morphology of the scaphoid.

Adolescent↗
PubMed1998

Operative treatment of displaced proximal humeral fractures: two-year results in 99 cases.

The operative treatment of comminuted and displaced fractures of the proximal humerus has been evolving in recent years. Classical open reduction and internal fixation techniques have an increased risk of avascular necrosis. Minimal osteosynthesis procedures often result in a suboptimal fracture reduction and require postoperative immobilization of the arm in some cases. This study reviewed ninety-nine out of 142 patients (70%), an average of 30 months (range 12 to 72 months) after indirect reduction and internal fixation of two-, three- or four-part fractures of the proximal humerus. The surgical procedure includes indirect fracture reduction with no manipulation of the different fracture fragments and subsequent buttress-plate fixation, using a limited deltopectoral approach. Mean age of patients was 63 years (range 17 to 85 years). Twenty percent of patients had associated lesions. Five patients presented with fracture-dislocations. Results were, according to the UCLA- and the Constant-rating system good to excellent in 76 and 69% of cases. Twelve patients had a poor functional outcome. The indirect reduction technique reduces the opening of the fracture site to minimum and thereby limits the risk of iatrogenic damage to local vascularity and the rotator cuff. Complete and partial humeral head necrosis developed in 3% and 1% of cases respectively. Non-union occurred in one case. Plate fixation is an adequate procedure for treating unstable and displaced two- to four-part fractures of the proximal humerus. The incidence of avascular necrosis and non-union are low, when fracture reduction is performed indirectly. Plate fixation enables an early functional treatment, with no need for postoperative immobilization.

Adolescent↗
PubMed1984

Four-part fractures of the neck of the humerus.

Four-part fractures of the upper end of the humerus are uncommon injuries and there is still dispute about the best form of management. A retrospective study of 32 patients with these injuries has shown that non-operative management is frequently followed by persistent pain, stiffness and dysfunction of the shoulder. A prospective study of 49 patients with this injury presenting at the Bristol Royal Infirmary has shown that reconstruction of the upper end of the humerus with insertion of a Neer prosthesis will usually restore comfort and function. Whichever regimen is employed, disability is prolonged and dedicated physiotherapy is essential in their management.

Adult↗
PubMed1995

Neer's classification system: a critical appraisal.

The purpose of this study was to examine the interobserver agreement using Neer's classification system for fractures of the proximal humerus. A preliminary series of 28 fractures of the proximal humerus admitted to the hospital over a 5-year retrospective period was independently assessed by two radiologists and two orthopedic surgeons. The degree of agreement between paired observations was determined using a kappa statistic. The observations were assessed according to the number of fracture segments, as well as site of fracture segment. Most of the patients assessed were multisegment tuberosity fractures (n = 18). Results showed that the overall agreement between pairs of observers was 65% (average kappa = 0.45). It was also shown that, within the tuberosity group, the percentage agreement was 50%, with an average kappa = 0.35, indicating only fair interobserver agreement. Clinical implications of these findings are such that, as major surgical decisions are made dependent on Neer's classification, closer evaluation techniques--such as the computerized tomography scan and magnetic resonance imaging--should be used to classify the fracture segments accurately. This is particularly true with the fractured tuberosity subgroup.

Adolescent↗