This surgical procedure repairs a break in the proximal end of the humerus. Their incidence is low under the age of 40 and rises almost exponentially with age. Proximal Humerus Fractures Speaker- Dr. Epidemiology Proximal humeral fractures represent around 5% of all fractures ?. Different operative techniques are available, but the hallmark of fixation for and fractures is a locking-plate-and-screw construct. It is best to space the exercise sessions out throughout the day, every 2-3 hours, to keep the flexibility during this important time of healing. In a young person, this kind of a break can happen after a severe trauma to the shoulder. Proximal Humerus Fracture. Hemiarthroplasty for Proximal Humeral Fractures: How Important Are the Tuberosities? Danny P. The humeral head makes up the end of the Humerus. Fortunately, there are a few treatment options following a shoulder fracture. There are many reasons why a person may experience humerus pain, including a humerus fracture, an elbow injury and a dislocated shoulder. Head and Neck fracture is treated by Dr Struhl in Westchester and White plains. Compared with non-surgical treatment, surgery does not result in a better outcome for the majority of people with displaced proximal humeral fractures and is likely to result in a greater need for subsequent surgery. PROXIMAL HUMERUS FRACTURE (NON-OPERATIVE) PHASE I (1-3 WEEKS) DATES: Appointments No PT for 3 weeks, unless otherwise specified by MD Rehabilitation Goals • Modalities to control pain and swelling • Protect fracture site • Maintain ROM in surrounding joints • Prevent deconditioning. But, this is only the take for bony union, it does not take into account the time that will be needed for full recovery. A proximal humerus fracture can greatly affect the shoulder joint and upper arm movement. It is the most common fracture of the shoulder region. It moves in the socket of the shoulder joint called the glenoid. Quick Answer. Intended Use The AxSOS 3 Titanium Locking Plate System is intended for long bone fracture. options in ORIF for proximal humeral fracture in patients with PD. Closed treatment proximal humeral fracture A humerus fracture can be classified by the location of the humerus involved: the upper end, the shaft, or the lower end. Design Case series. 5mm self-tapping cortical screws in the two top proximal plate holes. Osteoporotic fractures our initial clinical experience with the S3 system has produced so far highly satisfactory functional results. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. More severe shoulder fractures may require surgery to realign and stabilize the injury. A proximal humeral fracture can be a painful injury that limits your ability to move your arm and shoulder. This type of fracture may be caused by a fall, trauma from a car accident, or a sports injury. The MUTARS Silver Coated Proximal Humerus is available in standard and inverse options. Non-Operative Proximal Humeral Fracture Rehabilitation Protocol General Principles: 1. I was a little apprehensive as I still had some PTSD from the original surgery and recovery, so I was really scared that I was going to be miserable again. These injuries can occur to all ages as a result of a fall or direct trauma and it is crucial to undergo surgery when this fracture is displaced. The blood supply to the proximal humerus is a little unique, and that's where the treatment options vary. InfoSheet – Proximal Humerus Fractures David M. 0mm and the drill. The Univers II humeral component was designed to account for anatomical variations of the proximal humerus commonly encountered by the surgeon. Associate Professor of Orthopaedic Surgery, Drexel University, Director of Orthopaedic Trauma, Hahnemann University Hospital. Different operative techniques are available, but the hallmark of fixation for and fractures is a locking-plate-and-screw construct. ORIF stands for Open Reduction Internal Fixation. Bimodal distribution of forces on the elbow, usually caused by high energy injuries in the young, or secondary to falls in the elderly, can result in. of 04 I've had bone scan mri and a knee surgery to help the pain go away now they think the pain in my bone is coming from my back. A fracture to the humerus bone is a possible consequence of a traumatic event, such as a fall or forceful collision. Rehabilitation of Proximal Humerus & Clavicular Fractures 19 th Annual Primary Care Orthopaedic & Sports Medicine Symposium January 25, 2019. Most proximal humerus fractures do not require surgery. The humerus is your upper arm bone between your shoulder and elbow. Proximal humerus fractures 1. Proximal Humerus Fractures Speaker- Dr. Clinical evaluation was performed using the University of California at Los Angeles (UCLA) criteria. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. Case 7 FEATURING Gary Dean Harter, MD , Brian Leggin , James Krieg , Samir Mehta. Proximal humeral fractures are proximal to the surgical neck (see figure Key anatomic landmarks in the proximal humerus). Different operative techniques are available, but the hallmark of fixation for and fractures is a locking-plate-and-screw construct. What was done here was a Closed Manipulative Reduction of a Closed Fracture of the Proximal Humerus with Percutaneous Pin Fixation, with X-ray imaging of the fracture reduction and the placement of the pin fixation. As reported by Orthopedics Today, researchers reviewed data from 345 patients who underwent surgery for 349 proximal humerus fractures from January 2007 to June 2012. "The results of surgery may improve in future with the introduction of better techniques and the use of bone-strengthening agents, but currently we do not advocate the use of internal fixation to treat two-part fractures of the surgical neck of the proximal humerus regardless of the degree of initial displacement. Some medical centers specialize in joint surgery and tend to have higher success rates than less specialized centers. 216K - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more. Proximal Humerus Fractures • Defined as Fx occurring at or proximal to surgical neck • 80 % of all humeral # • 7% of all #. Most fractures of the proximal humerus can be treated without surgery if the bone fragments are not shifted out of position (displaced). Malunion of the proximal humerus Malunion may be encountered after conservative treatment or internal fixation of fractures, and also around a joint prosthesis. They result from direct trauma to the upper arm and shoulder or by axial loading through the lower arm. Metaphyso-diaphyseal extension 4. > Proximal Humerus fracture New 0300 13 14 500 main telephone number As part of an upgrade of our telephone system, we have a new 0300 13 14 500 main telephone number, whether you want to call Bexhill Hospital, Conquest Hospital or Eastbourne DGH – you just need to use one number – find out more>>. of Orthopaedic Surgery George Washington University School of Medicine Washington, DC Galway University Hospitals Galway, Ireland May 24, 2013. Proximal Humerus Fractures A proximal humerus fracture is the most common fracture of the shoulder which occurs at the upper end of the arm bone. A fracture of the proximal humerus means that the bone adjacent to the glenoid socket of the shoulder is broken (see below) Figure: The image on the left is an x-ray of a proximal humerus fracture. Surgical Exposures of the Humerus Location Procedure Clinical Example Surgical Approach Concerns and Limitations Proximal Total shoulder arthroplasty Conventional or reverse prosthesis Deltopectoral Axillary nerve, anterior humeral circumflex artery ORIF of the proximal humerus Three- or four-part fractures requiring open reduction. Thus, one must take into account all patient factors and medical comorbidities when considering surgery. On emergency. An incision is made on the side or front of the arm to allow access to the side of the humerus. Even if surgery takes care of most of your issues with your shoulder joint, you will likely be required to participate in physiotherapy and other follow-up treatments meant to help you regain flexibility and strength in your damaged shoulder after you've suffered a proximal humerus fracture. Proximal humeral fractures generally occur in older patients. This is performed through a 12cm incision over the front of your shoulder (fig. list of potential adverse effects and contraindications. Conclusions: Proximal humerus fractures carry similar risk factors, morbidity, mortality, and health care costs as other osteoporotic fracture types. We then clamped a Synthes proximal humerus locking plate in the plate and we inserted adequate expansion from proximal with at least four screws all distal to the fracture site. How Do Proximal humerus fractures occur?. General Information About Pain After A Fracture. The most useful rehabilitation protocol is the three-phase system. The T2 Proximal Humeral Nail is indicated for: • The T2 Proximal Humeral Nail is intended to be used for various types of proximal and/or diaphy-seal fractures of the humerus. Because of my arm being swollen way too much, I had an emergency surgery in Italy (I'm from Germany), but had it fixed with a different kind of osteosynthesis. A proximal humeral fracture can be a painful injury that limits your ability to move your arm and shoulder. Treatment is generally wi. Initially, treatment of proximal humerus fractures consisted of closed reduction, traction, casting, and abduction splints. Arthroplasty. He is a 25 year old male who presented with pain to his R shoulder in the ER and diagnosed with a proximal humerus fracture dislocation. A broken upper humerus can make everyday tasks that involve movement of your shoulder very difficult. These patients. Most fractures of the proximal humerus can be treated without surgery if the bone fragments are not shifted out of position (displaced). The image on the right is a CT scan of a proximal humerus fracture. Displaced fractures in younger patients. 2015;66(4S):S47. We offer planned orthopaedic surgery to people locally, nationally and internationally. In addition to the better exposure of the proximal humerus and of the glenoid, this approach makes it possible to detach and fix the greater tuberosity more easily with respect to the deltopectoral approach. Unstable,displaced 2, 3 and 4 part fractures 2. Methods Inclusion criteria were as follows: (i) diaphysis or meta-. Learn the Epiphyseal fibula transfer to proximal humerus following resection for osteosarcoma surgical technique with step by step instructions on OrthOracle. PDF | Proximal humerus fractures (PHF) account for 5-6% of all adult fractures[1]. A proximal humeral fracture is a broken bone that occurs near your shoulder joint. A humerus shaft fracture, on the other hand, is one that is localized at the mid portion of the upper arm. This protocol is for nondisplaced proximal humerus fractures, or patients stable fractures after surgical fixation. HealthTap: Doctor answers on Symptoms, Diagnosis, Treatment, and More: Dr. Rehabilitation guidelines following Proximal Humeral Replacement Surgery. Proximal humerus fractures are common orthopaedic injuries that usually occur as a result from a direct blow to the shoulder, either in a fall or as the result of a high-energy trauma. Associate Professor of Orthopaedic Surgery, Drexel University, Director of Orthopaedic Trauma, Hahnemann University Hospital. The Neer classification system helps to guide treatment of these fractures. There truly is not a consensus on best practices for treatment of proximal humerus fractures [55, 56]. A majority of proximal humeral fractures are preferably treated conservatively. the shoulder is the proximal portion of the humerus. The findings of the present study are clinically relevant, as life expectancy continues to increase and the Medicare population continues to grow. 4, 2016 • www. significant intraosseous anastamoses between the arcuate artery ; posterior circumflex humeral artery, metaphyseal arteries, vessels of the greater and lesser tuberosities. Proximal Humerus Fractures: The Last. Univers II Shoulder System. The proximal humerus refers to the upper end of the arm bone, which forms shoulder joint. The mean follow-up time was 12 months and the mean age of patients was 57 years. Information concerning the outcome after removal of hardware from the proximal humerus is lacking and most studies on hardware removal are focused on the lower extremity. Stress fractures can occur with overhead throwing (cricket and baseball players). PDF | Proximal humerus fractures (PHF) account for 5-6% of all adult fractures[1]. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. The surgeon must discuss all relevant risks, including the finite lifetime of the device, with the patient, when necessary. Proximal humeral fractures are one of the most common upper extremity fractures seen by ortho-pedic surgeons. ORIF stands for Open Reduction Internal Fixation. Epiphyseal hematopoietic marrow was more prominent in female subjects (P =. Intended Use The AxSOS 3 Titanium Locking Plate System is intended for long bone fracture. Therefore the aim of this study was to analyze the functional short-term outcome following removal of locking plate fixation of the proximal humerus. Arrow shows the junction between the ball and the shaft, called the surgical neck. benefit of surgery instructions for use being attached to every implant. Fixation of the Proximal Humerus Our orthopaedic shoulder surgeons are all fellowship trained and specialize specifically in shoulder surgery. Surgery typically involves fixing of the fracture with plates and screws or rods inside the bone. Broken bones hurt. Proximal Humerus Fractures: The Last. Calcar screws. Hardware Removal - Best Decision EVER! I had the hardware removed on November 22nd, 2013. The literature review will only include prospective studies for proximal humerus fractures in which conservative management and rehabilitation is advocated. If the fragments are shifted out of position, surgery is usually required. Frozen Shoulder after ORIF surgery. Our e-learning platform contains high resolution images and a certified CME of the Epiphyseal fibula transfer to proximal humerus following resection for osteosarcoma surgical procedure. Compared with non-surgical treatment, surgery does not result in a better outcome for the majority of people with displaced proximal humeral fractures and is likely to result in a greater need for subsequent surgery. Proximal humerus fracture is diagnosed by physical examination, X-ray of the affected area and/or computerized tomography (CT) scan. Contraindications for repair of proximal humerus fractures include inability to tolerate the procedure medically and lack of clearance for surgery through the primary care physician or specialty consultants. 691-697) A 2006 Finnish. Physiotherapeutic interventions and rehabilitation regimen of the surgically stabilized proximal humeral fracture – a literature review Author Tutor Rosén, Kajsa, RPT Ljunggren Ribom, Eva, RPT, PhD Uppsala University hospital Uppsala University hospital Examined 14/6 2010 by Birgitta Lindmark RPT, Ph. These patients. Different operative techniques are available, but the hallmark of fixation for and fractures is a locking-plate-and-screw construct. Proximal humeral fractures are common upper extremity fractures, particularly in older patients, and can result in significant disability. Slipped on ice on Jan 9 2015 had ORIF surgery on left humerus on Jan 112015. If you continue to browse this website, we will assume that you are happy to receive all our cookies. Fractures of the humerus can occur proximally, in the shaft (diaphysis), or distally. It is common now for broken bones (fractures) to be fixed with metal plates and screws or a long nail, especially if the fracture is unstable or the joint surface has been damaged, and for this hardware to be left in the body. Proximal Humerus Fractures: contemporary perspectives Diego L Fernandez M. Fractures to the upper arm, also known as proximal humerus fractures are a common fracture in low energy injuries, especially in those with osteoporosis. Proximal humerus fractures in children can commonly be treated non-operatively due to the large amount of bone growth that occurs at the proximal humerus. This surgical procedure repairs the break in proximal end of the humerus by using an ORIF (open reduction internal fixation). This required multiple surgeries to achieve, and for the duration of the treatment, the patient had to stay in hospital as an in-patient. The Humerus is the upper arm bone between the shoulder and the elbow. Shoulder Fractures are among the most common breaks of the human skeleton. The purpose of the project is to compare surgical and conservative management of two- part PHFs in light of radiological, economical. Proximal humerus fractures can be categorised into 4 groups: Greater tuberosity fractures : Greater tuberosity is the insertion site for attachment of rotator cuff tendons. 21–25 The most common reason for subpar out. Epidemiology Proximal humeral fractures represent around 5% of all fractures ?. Data from medical records were collected retrospectively. Proximal humerus fractures are common injuries in the elderly. This can have a significant impact on your. Once the lesion is considered benign, emphasis can be placed on identifying the etiology for the pain. Surgery is sometimes undertaken in an attempt to put the pieces back in a more proper position and maintain that position with plates, screws, wires, and the like. There truly is not a consensus on best practices for treatment of proximal humerus fractures [55, 56]. Compared with open reduction and internal fixation, external fixation for displaced proximal humeral fractures avoids dissection and soft tissue stripping and leads to higher union rates, a lower incidence of avascular necrosis, less scaring of the scapulohumeral interface, and faster rehabilitation. 015) and showed correlation with prominence of hematopoietic marrow within the proximal humeral metaphysis (P =. Our e-learning platform contains high resolution images and a certified CME of the Lima SMR Reverse Total Shoulder Replacement for proximal humeral fracture surgical procedure. Choosing surgical approaches to proximal humerus fractures OrthoClips. My adventures in shoulder rehab after fracturing my proximal humerus and undergoing open reduction internal fixation (ORIF) to correct Health , humerus , ORIF , recovery , shoulder , surgery Product review: Shamrock Triple Pullup, Dip and Suspension Gym. Approximately 70-80% of. A PROSPECTIVE REVIEW OF 43 CASES WITH SHORT-TERM FOLLOW UP TO REVIEW IS TO OPINE The management of complex proximal humeral fractures in the elderly continues to be a difficult problem to solve with a predictable solution. Orthopedics | Proximal humerus fractures in elderly patients are a common injury that can often be treated nonoperatively. Design Case series. The calculated blood loss and the transfusion rate were analyzed depending on the type of surgery (plate fixation, arthroplasty, and others) or the fracture classification (2-, 3-, and 4. Surgery Theater, with more than 12,000 educational surgery videos, is the world’s first online social medical video sharing for all health care professionals. Metaphyso-diaphyseal extension 4. Hemiarthroplasty for Proximal Humeral Fractures: How Important Are the Tuberosities? Danny P. The bone quality is typically poor, and the proximal bone stock is limited. ORIF stands for Open Reduction Internal Fixation. 216K - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more. A PROSPECTIVE REVIEW OF 43 CASES WITH SHORT-TERM FOLLOW UP TO REVIEW IS TO OPINE The management of complex proximal humeral fractures in the elderly continues to be a difficult problem to solve with a predictable solution. The recent advances in plate fixation methods have significantly reduced the rates of the complications, thus lessening the need for head replacing surgery. Nursing care planning of a patient with a fracture, whether in a cast or in traction, is based upon prevention of complications during healing. Using an arthroscopic approach, these lesions can be visualized, decompressed and curettage, with the ability to evaluate the extent of pathologic tissue remaining. Fractures of proximal humerus are common in elderly individuals, suffering from osteoporosis. The ball-shaped head of the humerus (upper arm) fits in the glenoid cavity in such a manner, it moves freely in the socket. A fracture of the proximal humerus means that the bone adjacent to the glenoid socket of the shoulder is broken (see below) Figure: The image on the left is an x-ray of a proximal humerus fracture. A proximal humerus fracture occurs when the "ball" of the ball-and-socket shoulder joint is broken. The cause is generally a fall onto the arm or direct trauma to the arm. This surgical procedure repairs a break in the proximal end of the humerus. Femoral allograft for proximal humeral fractures See more. To ensure the bone healed in the correct position, Janet had surgery at an outside hospital that involved. The humerus is the bone in the upper part of your arm. Bony healing occurs usually within 6 to 8 weeks in adults 2. Fractures of the humerus can occur proximally, in the shaft (diaphysis), or distally. ORIF stands for Open Reduction Internal Fixation. Sometimes surgery for proximal humerus fractures involves removing the ball of the shoulder and performing a shoulder hemiarthroplasty. ORIF Surgery for Proximal Humerus Fracture Surgical Procedure Most fractures of the proximal humerus can be treated without surgery if the bone fragments are not shifted out of position (displaced). Like fractures of the femoral neck they have become a public health concern. Proximal Humeral Fracture Post-Surgical Rehabilitation Protocol (OPEN REDUCTION / INTERNAL FIXATION) General Principles: 1. In a humeral fracture, fracture fragments may move away from their normal anatomical position,. Medical treatment for a proximal humeral fracture most often includes a period of immobilization using a sling, with the arm slightly abducted. benefit of surgery instructions for use being attached to every implant. ORIF Surgery for Proximal Humerus Fracture This surgical procedure repairs a break in the proximal end of the humerus. The part of the Humerus closest to the shoulder is known as the 'Proximal Humerus'. Dines, MD, and Joshua S. The Sleeve System – Screw holes are accessible by sleeve system for percutaneous screw on erti sn i – Outer sleeves snap into the aiming arm for quick assembly and removal – Different drill sleeves for the option of locking and cortex screw insertion – Color-coding facilitates system. A broken humerus where bone fragments have not been. The specific risks associated with reverse geometry total shoulder replacement can be seen in the shoulder arthroplasty / replacement section. HealthTap: Doctor answers on Symptoms, Diagnosis, Treatment, and More: Dr. Proximal humerus fractures account for 5% of all fractures of the appendicular skeleton. ORIF Surgery for Proximal Humerus Fracture Osteoarthritis of the Shoulder Proximal Humerus Fracture (Broken Shoulder) Reverse Total Shoulder Replacement Rheumatoid Arthritis (RA) of the Shoulder Rotator Cuff Injuries Rotator Cuff Tears Shoulder Dislocations Shoulder Impingement Syndrome Shoulder Impingement Surgery Shoulder Separation SLAP Tear. We present a novel, arthroscopic technique to treat intraosseous ganglion lesions of the proximal humerus. While nonoperative treatment of some fracture patterns results in clinical success, other, more displaced and comminuted fractures may require surgery to ensure a successful outcome. The neck is a frequent site of fracture. A plate with screws is the choice of many surgeons currently. Extension and Internal Rotation not performed until 6 weeks 4. ORIF stands for Open Reduction Internal Fixation. Proximal Humerus) Introduction. Greater tuberosity fractures are less common and are seen in cases of shoulder dislocations and in those with osteoporosis. Proximal Humerus Fractures A proximal humerus fracture is the most common fracture of the shoulder which occurs at the upper end of the arm bone. This could not be done without some form of general anesthesia, provided by an Anesthesiologist &/or CRNA. Diagnosis is generally based on X-rays or CT scan. Humeral head-split fractures, in which a portion of the humeral head breaks and disrupts the cartilage of the joint. J Shoulder Elbow Surg 2011:20(8):1234-40. Most fractures of the proximal humerus can be treated without surgery if the bone fragments are not shifted out of position (displaced). of 04 I've had bone scan mri and a knee surgery to help the pain go away now they think the pain in my bone is coming from my back. hi, i fractured my proximal humerus 3 weeks ago, body surfing in india, first day spent in absolute agony without pain relief, then taken for surgery to have it plated, with ten pins. Merriman on distal humerus fracture recovery: In children a supracondylar humerus fracture is the most common fracture which requires surgery. Fractures of the head of the humerus are usually seen in young dogs with open, growing physes. Proximal Humerus Fractures WHAT IS A PROXIMAL HUMERUS FRACTURE? The proximal humerus is the upper part of the arm bone. Surgery for a proximal humerus fracture can include: suture anchor fixation, plate and screw fixation, intramedullary nail or joint replacement. The humerus goes from the shoulder joint to the elbow joint and must be strong enough to take a good deal of weight when you lift something or push against something. A PROSPECTIVE REVIEW OF 43 CASES WITH SHORT-TERM FOLLOW UP TO REVIEW IS TO OPINE The management of complex proximal humeral fractures in the elderly continues to be a difficult problem to solve with a predictable solution. A PROSPECTIVE REVIEW OF 43 CASES WITH SHORT-TERM FOLLOW UP TO REVIEW IS TO OPINE The management of complex proximal humeral fractures in the elderly continues to be a difficult problem to solve with a predictable solution. Rehabilitation therapy, as described above, begins as soon as possible. Arthroplasty for proximal humerus fractures is a good surgical option for low-demand elderly patients, or fractures that are not amenable to ORIF. 5 weeks being the average. This makes it easier for your humerus to heal on its own. Surgery is sometimes undertaken in an attempt to put the pieces back in a more proper position and maintain that position with plates, screws, wires, and the like. Thus, one must take into account all patient factors and medical comorbidities when considering surgery. Non-Operative Proximal Humeral Fracture Rehabilitation Protocol General Principles: 1. Calcar screws. Proximal humerus fractures include fractures involving the proximal humeral physis and metaphysis. Treatment is generally wi. I can feel a teeny tiny muscle there, so I know he didn't remove It, or at least all of it. Surgery is generally believed to be required in only about 20% of patients with proximal humerus fractures (PHFs) [2]. The system introduces a number of improvements to both the implants and the instrumentation when compared to the prior generation. Research sponsored by Teleflex Incorporated. Revision surgery due to humeral fracture. ORIF Surgery for Proximal Humerus Fracture | Reconstructive Orthopedics, Sewell, NJ. Is the bone healed yet? Are you using a co-apt, or clam shell, brace when doing your therapy?. Federal Government. Ligament Attachments: Epiphyses: Blood Supply: Fractures: Distal Humeral Fractures. ORIF stands for Open Reduction Internal Fixation. In a young person, this kind of a break can happen after a severe trauma to the shoulder. For the surgical procedure, report 24516 (open treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws). , (22) in a 2015 study of factors that influenced reduction loss after proximal humerus fracture surgery, reported that postoperative head shaft angles of patients who maintained reduction were greater than those who lost reduction (mean: 130[degrees] versus 123[degrees]). This surgical procedure repairs the break in proximal end of the humerus by using an ORIF (open reduction internal fixation). Welcome to Advantage Physiotherapy’s guide to adult humerus fractures. This surgical procedure repairs a break in the proximal end of the humerus. They usually can be treated conservatively with immobilization but more complex fracture patterns often require operative treatment. This approach is also highly recommended for revision surgery. Shoulder arthrodesis is an appropriate salvage procedure but is associated with a high rate of complications. Regardless of the type of treatment used,. Humeral fractures can be classified into three types, depending on which part of the bone is broken. In adults, the fracture often involves the joint, which needs to be anatomically aligned. If you are looking for exercises to do following a proximal shoulder fracture, whether you need surgery or not, visit the shoulder exercises section. The risks associated with open reduction internal fixation had led us to develop and apply a "hybrid. The humerus joins with the shoulder blade to form the shoulder joint and the bones of the forearm (radius and ulna) to form the elbow (figure 1). If you’ve had surgery for a proximal humerus fracture or a bicep tear, you will probably also leave the hospital with a sling for your affected arm. You will have some sharp pains in this area because of this. require a replacement of the humeral head. ORIF of fracture proximal humerus You’ve been listed for an operation ORIF (open reduction and internal fixation) of the proximal humerus (the top end of your arm bone). Sometimes surgery is needed. Ideally, surgeons like to perform surgery within 1-2 weeks of injury. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. John Macy, MD. All patients underwent open reduction and internal fixation with proximal humerus locking plate through either delto-pectoral or deltoid splitting approach. Treatment of these injuries is most commonly coordinated by a physician (usually an orthopedic surgeon) and can require surgery to reconnect the broken part of the bone to the humerus or rest with a prolonged period of splinting to allow healing to take place. Proximal humerus fractures can be categorized into 4 groups: • Greater tuberosity fractures: Greater tuberosity is the insertion site for attachment of rotator cuff tendons. See Rotator Cuff Injuries. Using an arthroscopic approach, these lesions can be visualized, decompressed and curettage, with the ability to evaluate the extent of pathologic tissue remaining. Most proximal humerus fractures occur in people older than 65, and about half of the fractures are displaced, meaning that the two ends of the bones are separated from each other. An x-ray revealed that my left humerus was badly fractured (spiral) in four places and the doctors said surgery would be needed as soon as possible. PROXIMAL HUMERUS FRACTURE - ORIF PHASE I (1-3 WEEKS) DATES: Appointments • Begin physical therapy at 1 week post op, 2 x/week • Follow up with MD 10-14 days post op. This approach is also highly recommended for revision surgery. This can have a significant impact on your. The Humerus is the upper arm bone between the shoulder and the elbow. 33 Proximal Humerus Resection. The clavicle functions as a strut connected to the shoulder bone (scapula). It is best to space the exercise sessions out throughout the day, every 2-3 hours, to keep the flexibility during this important time of healing. org rotator cuff insertion onto the greater tuberosity. Compared with open reduction and internal fixation, external fixation for displaced proximal humeral fractures avoids dissection and soft tissue stripping and leads to higher union rates, a lower incidence of avascular necrosis, less scaring of the scapulohumeral interface, and faster rehabilitation. This prevents stiffness in the shoulder. ORIF stands for Open Reduction Internal Fixation. The proximal humerus is part of the shoulder joint, and the distal humerus is part of the elbow joint. Bimodal distribution of forces on the elbow, usually caused by high energy injuries in the young, or secondary to falls in the elderly, can result in. Proximal humeral fractures are common upper extremity fractures, particularly in older patients, and can result in significant disability. The proximal Humerus is the ball shaped portion of the Humerus, or the top part of the arm bone. 5 Fractures and tendon injuries of the athletic shoulder. Certain lesions are commonly associated with fractures to specific areas of the humerus. He is a 25 year old male who presented with pain to his R shoulder in the ER and diagnosed with a proximal humerus fracture dislocation. Like fractures of the femoral neck they have become a public health concern. proximal: [ prok´sĭ-mal ] nearest to a point of reference, as to a center or median line or to the point of attachment or origin. Why do some proximal humerus fractures require surgery? The proximal humerus is part of the shoulder joint, and it also is the attachment of the important rotator cuff muscles. Stable Proximal Humerus Fracture. The proximal humerus receives its blood supply from branches of the axillary artery while anterior and posterior humeral circumflex arteries originate distal to the anatomic neck and travel proximally to supply the humeral head. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. Discussion: Proximal humerus fractures occur at about seventy percent the rate of proximal femoral fractures, but only about nine percent of these are three-part fractures and still fewer (three percent) are four-part fractures (11, 25). Surgery is generally believed to be required in only about 20% of patients with proximal humerus fractures (PHFs) [2]. Most of these fractures can be treated with a sling, a swathe, and early mobilization. The image on the right is a CT scan of a proximal humerus fracture. proximal: [ prok´sĭ-mal ] nearest to a point of reference, as to a center or median line or to the point of attachment or origin. Humerus is the upper arm bone and it forms two joints - shoulder joint and elbow joint. I'm very concerned about one issue though. Stable Proximal Humerus Fracture. Proximal Humerus; Total Humerus Replacement; Distal Humerus/Total Elbow; Proximal Femur Tumor; Pelvis & Acetabular; Distal Femur Tumor; Total Femur Prosthesis; Proximal Tibia Tumor; Cryosurgery; Radical Resection; Resections of Bony Tumors; Radiofrequency Ablation; Saddle Prosthesis; Shoulder Tumors. No clear repair technology or ap-proach has proven to be preferred in clinical literature. With plate fixation of a proximal humeral fracture complications are rare, but include a risk of infection, damage to nearby nerves/blood vessels and delayed or non-healing of the break despite surgery. 5 Fractures and tendon injuries of the athletic shoulder. It allows accurate alignment of the fracture fragments and a stable fixation to promote early rehabilitation and return to function. NCB Proximal Humerus Plating System Surgical Technique 1111 Proximal ∅ 3. Greater tuberosity fractures are less common and are seen in cases of shoulder dislocations and in those with osteoporosis. Proximal humerus fractures are common, and about 80% are well managed nonsurgically. 0mm cancellous screws and a range of 4. Proximal humeral fractures should be described in relation to: Displacement - a percentage of the humeral shaft diameter; Angulation of neck shaft - varus (decreased) or valgus (increased) Figure 1: AP and lateral x-ray of 10 year old girl with Salter-Harris type II fracture of the proximal humerus. These patients. Louis should be consulted about surgery if the fragments have shifted or been pulled out of position. Periodic X-rays will be obtained to be sure the fracture is healing. This innovative plating system for the treatment of the Proximal Humeral Fractures consists of anatomically contoured left and right plates with a low head profile. Proximal humerus fractures occur when the humerus (the upper arm bone) is broken at the proximal end—that is, the end that is closest to the shoulder. Rehabilitation guidelines following Proximal Humeral Replacement Surgery. Fractures of this region are common both with high-energy. Proximal Humeral Epiphysiolysis (Little Leaguer’s Shoulder) Little Leaguers’ Shoulder is a term that is used to describe pains and discomforts that pitchers and other overhead athletes have in their shoulder when the growth plate in the upper arm (humerus) is injured. Different operative techniques are available, but the hallmark of fixation for and fractures is a locking-plate-and-screw construct. PDF | Proximal humerus fractures (PHF) account for 5-6% of all adult fractures[1]. ORIF stands for Open Reduction Internal Fixation. Proximal humerus fractures can be categorized into 4 groups: Greater tuberosity fractures : Greater tuberosity is the insertion site for attachment of rotator cuff tendons. Objective To evaluate the presence of x ray changes in the proximal humerus growth plate of 21 young pitchers. In particular, surgical fixation of the proximal humerus in elderly patients carries a higher risk of implant failure and reoperation (between 19% and 30%). The Sleeve System – Screw holes are accessible by sleeve system for percutaneous screw on erti sn i – Outer sleeves snap into the aiming arm for quick assembly and removal – Different drill sleeves for the option of locking and cortex screw insertion – Color-coding facilitates system.