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proLékaře.cz / Journals / Perspectives in Surgery / 2024 - 5

Current treatment strategy for proximal humerus fractures

Czech version

Authors: M. Kloub 1;  M. Doležalová Hrubá 1,2;  T. Zídek 1,2
Authors‘ workplace: Oddělení úrazové chirurgie Nemocnice České Budějovice, a. s., Česka republika 1;  Lékařská fakulta Univerzity Karlovy v Plzni, Česká republika 2
Published in: Rozhl. Chir., 2024, roč. 103, č. 5, s. 147-159.
Category: Review
doi: https://doi.org/10.33699/PIS.2024.103.5.147–157

Overview

Fractures of the proximal humerus present a unique challenge in orthopedic practice due to the complex anatomy and biomechanical complexity of this region. The spectrum of injuries occurring here ranges from nondisplaced stable fractures to complex displaced fractures or fracture-dislocations. Historically, the treatment of these fractures has been the subject of much debate and treatment modalities have mainly involved a conservative approach, with surgical management being relatively rare. In recent decades, there has been a paradigm shift in the treatment of proximal humerus fractures not only due to advances in surgical techniques, but especially with the development of new types of angular-stable implants and modern total arthroplasties. The development and availability of high-quality imaging techniques have enabled better understanding of the nature of fractures and precise planning of surgical interventions. The main goals of treatment include restoration of function, pain relief and prevention of complications such as prolonged healing or non-healing and avascular necrosis. An individualized approach to each individual patient, considering all factors that affect the final outcome, appears to be essential in the choice of treatment. The aim of this review article is to provide an up-to-date overview of the current concept of treatment of proximal humerus fractures. Trends in nonoperative and operative treatment strategies, indications for each type of treatment, operative techniques, outcomes, and complications associated with each approach are summarized. 

Keywords:

trauma – Arthroplasty – upper limb – fracture – proximal humerus

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  25. Su F, Nuthalapati P, Feeley BT, et al. Outcomes of anatomic and reverse total shoulder arthroplasty in patients over the age of 70: a systematic review. JSES Rev Rep Tech. 2023;3:181–188. doi:10.1016/j. xrrt.2023.02.003.

MUDr. Martin Kloub, Ph.D.
Oddělení úrazové chirurgie
Nemocnice České Budějovice, a. s.
e-mail: kloub.martin@nemcb.cz

Labels
Surgery Orthopaedics Trauma surgery
Quo vadis trauma surgery in the Czech Republic
Current clinical applications of 3D printing in the management of complex fractures
Therapy of bone infection with an antibiotic cement-coated intramedullary nail – preliminary results
Fractures of the posterior malleolus as a part of complex ankle fractures: Trends in diagnosis and treatment at our institution
Conservative therapy for acromioclavicular joint dislocation – Rockwood III: a cohort analysis
Prophylactic osteosynthesis of long bones in patients with multiple myeloma
Intraosseous ganglion cyst of the scaphoid with an extraosseous component –an uncommon cause of volar wrist pain: case report and literature review
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