Fractures of the proximal humerus

Fractures of the proximal humerus

In fractures of the proximal humerus consideration is given to the vascularity of the humeral head. The most common classification of the proximal humerus is the Neer classifica tion, which looks at the four individual pieces of the proximal humerus (articular head fragment, lesser tuberosity , greater tuberosity and the shaft). If a fragment is displaced by more than 1 /uni00A0 cm or angulated by more than 45° in respect of another fragment, it is consid h, based on the fracture pattern, it may be ered a part. As suc undisplaced, or in two parts, three parts or four parts. Con tion is then given to potential joint dislocation, anterior sidera or posterior. The greater the number of parts, the higher the hances of interruption of the vascularity to the humeral head c and the more complex the injury . hree factors can be used to predict avascularity of the T humeral head: 1 fracture through the anatomical neck; 2 loss of the medial hinge; 3 less than 8 /uni00A0 mm of bone along the medial calcar. In situations where there is a high risk of failure of both fixation and non-operative treatment, owing to avascular necrosis or implant fixation failing from bone loss or loss of function (e.g. with displaced fractures in lower demand patients osis and other comorbidities), consid and those with osteopor eration may be given to replacing the humeral head. This may Charles Sumner Neer II , 1917–2011, American orthopedic surgeon, emeritus professor at Columbia University , developed a widely used shoulder prosthesis and also developed a common classification system for proximal humerus fractures. limitations of trauma hemiarthroplasty for proximal humeral fractures involves r eliable healing of the tuberosities and the rotator cu ff . Increasingly , a primary reverse polarity shoulder prosthesis is being used. This implant does not rely on tuber - osity healing, as it functions under the power of the deltoid muscle. In younger patients reduction and fixation may be consid - e available: percutaneous ered. A variety of fixation methods ar fixation, intramedullary nails and plate fixation.

Figure 32.25 (a–c) A B-type humeral shaft fracture. This fracture could not be controlled by non-operative means and was treated with lag screws protected by a plate.

Fractures of the proximal humerus

In fractures of the proximal humerus consideration is given to the vascularity of the humeral head. The most common classification of the proximal humerus is the Neer classifica tion, which looks at the four individual pieces of the proximal humerus (articular head fragment, lesser tuberosity , greater tuberosity and the shaft). If a fragment is displaced by more than 1 /uni00A0 cm or angulated by more than 45° in respect of another fragment, it is consid h, based on the fracture pattern, it may be ered a part. As suc undisplaced, or in two parts, three parts or four parts. Con tion is then given to potential joint dislocation, anterior sidera or posterior. The greater the number of parts, the higher the hances of interruption of the vascularity to the humeral head c and the more complex the injury . hree factors can be used to predict avascularity of the T humeral head: 1 fracture through the anatomical neck; 2 loss of the medial hinge; 3 less than 8 /uni00A0 mm of bone along the medial calcar. In situations where there is a high risk of failure of both fixation and non-operative treatment, owing to avascular necrosis or implant fixation failing from bone loss or loss of function (e.g. with displaced fractures in lower demand patients osis and other comorbidities), consid and those with osteopor eration may be given to replacing the humeral head. This may Charles Sumner Neer II , 1917–2011, American orthopedic surgeon, emeritus professor at Columbia University , developed a widely used shoulder prosthesis and also developed a common classification system for proximal humerus fractures. limitations of trauma hemiarthroplasty for proximal humeral fractures involves r eliable healing of the tuberosities and the rotator cu ff . Increasingly , a primary reverse polarity shoulder prosthesis is being used. This implant does not rely on tuber - osity healing, as it functions under the power of the deltoid muscle. In younger patients reduction and fixation may be consid - e available: percutaneous ered. A variety of fixation methods ar fixation, intramedullary nails and plate fixation.

Figure 32.25 (a–c) A B-type humeral shaft fracture. This fracture could not be controlled by non-operative means and was treated with lag screws protected by a plate.

Fractures of the proximal humerus

In fractures of the proximal humerus consideration is given to the vascularity of the humeral head. The most common classification of the proximal humerus is the Neer classifica tion, which looks at the four individual pieces of the proximal humerus (articular head fragment, lesser tuberosity , greater tuberosity and the shaft). If a fragment is displaced by more than 1 /uni00A0 cm or angulated by more than 45° in respect of another fragment, it is consid h, based on the fracture pattern, it may be ered a part. As suc undisplaced, or in two parts, three parts or four parts. Con tion is then given to potential joint dislocation, anterior sidera or posterior. The greater the number of parts, the higher the hances of interruption of the vascularity to the humeral head c and the more complex the injury . hree factors can be used to predict avascularity of the T humeral head: 1 fracture through the anatomical neck; 2 loss of the medial hinge; 3 less than 8 /uni00A0 mm of bone along the medial calcar. In situations where there is a high risk of failure of both fixation and non-operative treatment, owing to avascular necrosis or implant fixation failing from bone loss or loss of function (e.g. with displaced fractures in lower demand patients osis and other comorbidities), consid and those with osteopor eration may be given to replacing the humeral head. This may Charles Sumner Neer II , 1917–2011, American orthopedic surgeon, emeritus professor at Columbia University , developed a widely used shoulder prosthesis and also developed a common classification system for proximal humerus fractures. limitations of trauma hemiarthroplasty for proximal humeral fractures involves r eliable healing of the tuberosities and the rotator cu ff . Increasingly , a primary reverse polarity shoulder prosthesis is being used. This implant does not rely on tuber - osity healing, as it functions under the power of the deltoid muscle. In younger patients reduction and fixation may be consid - e available: percutaneous ered. A variety of fixation methods ar fixation, intramedullary nails and plate fixation.

Figure 32.25 (a–c) A B-type humeral shaft fracture. This fracture could not be controlled by non-operative means and was treated with lag screws protected by a plate.