Conservative vs Surgical Treatment for Proximal Humerus Fractures in the Elderly

Launched by UNIVERSITY OF SAO PAULO · Sep 21, 2016

Keywords

ClinConnect Summary

Different methods have been used in the treatment of proximal humeral fractures. Usually, treatment choice depends on fracture displacement, patient age, osteoporosis, and other characteristics. Locking plate fixation has become the most widely used method among surgical techniques, while partial arthroplasty is reserved for older patients and comminuted articular fractures. Generally, nonsurgical treatment involves a brief period with sling immobilization and physiotherapy rehabilitation.

A recent multicenter study showed no difference between conservative and surgical treatments, includi...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• * Proximal humeral fractures, involving humeral head, with at least one of the following parameters:
• • Head-shaft angle between 100-200° or \>175° on coronal plane;
• • Shaft translation (on coronal or sagittal plane) \> 1cm;
• • Tuberosity displacement \> 0,5cm;
• • Head shaft angulation \>45° in axial or sagittal plane;
• • Less then 30 days
• Exclusion Criteria:
• • No contact between shaft and humeral head
• • Head-shaft angle \<100° on coronal plane
• • Articular head fracture with displacement \> 2mm
• • Fracture-dislocation
• • Bilateral fracture
• • Open fracture
• • Ipsilateral or contralateral superior limb fracture
• • Pathological fracture (tumors or bone disease, except for osteoporosis)
• • Previous rotator cuff complete tear
• • Previous infection
• • Neurological injury
• • Previous shoulder surgery
• • Inability to answer subjective scores