How to improve the outcomes of surgically treated proximal humeral osteoporotic fractures? A narrative review

Proximal humeral fractures (PHF) are the third most common non-vertebral fragility fractures after hip and distal radius. It still controversial which treatment might be more appropriate, and surgically treated outcomes depends also on an appropriate technique. In order to clarify surgical indicatio...

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Bibliographic Details
Main Authors: Antonio Benedetto Cecere, Giuseppe Toro, Annalisa De Cicco, Adriano Braile, Marco Paoletta, Giovanni Iolascon, Alfredo Schiavone Panni
Format: Article
Language:English
Published: Open Medical Publishing 2020-08-01
Series:Orthopedic Reviews
Subjects:
Online Access:https://www.pagepress.org/journals/index.php/or/article/view/8529
Description
Summary:Proximal humeral fractures (PHF) are the third most common non-vertebral fragility fractures after hip and distal radius. It still controversial which treatment might be more appropriate, and surgically treated outcomes depends also on an appropriate technique. In order to clarify surgical indications, tips and pitfall a narrative review was conducted. Pinning, external fixation, plating and internal fixators has each one its advantages and disadvantages. During the procedure an appropriate use of the fixation device and handling of the soft tissue might be associated with better outcomes. Calcar comminution, varus angulation, medial dislocation of the shaft, fracture-dislocation are factors that could lead to choose a replacement. Hemiarthroplasty and reverse total shoulder arthroplasty are the most common prosthesis used in PHF. The restoration of humeral length and tuberosities might lead to an improvement in clinical outcomes and prosthesis survivorship.
ISSN:2035-8237
2035-8164