Ability to restore stability of the fracture with anatomic restoration in surgically treated fractures.
Willingness of the patient to undergo lengthy rehabilitation.
The overall prognosis from proximal humerus fractures depends on numerous factors, including the following: Explain interprofessional team strategies for enhancing care coordination and communication to advance the evaluation and management of humerus fractures and improve patient outcomes. The personality of the fracture (eg, bone quality, fracture orientation, concurrent soft tissue injuries), the personality of the patient (eg, compliant, realistic expectations, mental status), and the personality of the surgeon (eg, surgical experience, technical familiarity, available resources) all have a tremendous effect on specific treatment indications.īelow are two examples of displaced fractures that require surgical fixation: Summarize the treatment considerations for humerus fractures. The decision for surgery and the surgical methods require a skilled and experienced surgeon and a motivated patient. The fracture pattern can be complex and difficult to assess adequately with plain x-rays, so a CT scan may be required to better understand the severity of the fracture. The parts that most commonly produce these fragments are the humeral head, the greater and lesser tuberosities, and the surgical neck. The most common definition of displacement is 1 cm between fragments or 45° of angulation between fracture fragments. Stress fractures most commonly occur in caudal aspect of proximal metaphysis and distal aspect of cranial/caudal metaphysis. A supportive sling followed by early rehabilitation and have good functional outcomes.ĭisplaced fractures require reconstuction, because if left untreated will have a high likelihood of producing limited function. Most fractures are minimally displaced and stable, so surgical fixation is not required. The treatment objective in proximal humerus fractures is to allow bone and soft tissue healing in a normal anatomical position to maximise function of the upper extremity. Proximal humerus fractures (PHFs) account for 5 to 6 percent of all adult fractures and often occur in elderly individuals who experience low-energy falls. In younger patients, high-energy trauma is the cause of injury. The most common mechanism for these fractures is a fall on the outstretched hand from a standing height. These fractures tend to occur in older patients who are osteoporotic. Fractures of the proximal humerus are common, accounting for 5% of all fractures.
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