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ORIF in Three-/Four-Part Fractures

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Simple and Complex Fractures of the Humerus

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Abstract

Proximal humerus fractures represent about 5 % of all fractures, and recent studies show that their incidence in the population over 75 years rises exponentially, with a probable increase of 250 % in the next 30 years. Three-part and four-part fractures represent a share of 13–16 % of the total amount of proximal humerus fractures. It is troublesome to indicate a universally accepted method of treatment, mainly because retrospective studies and meta-analyses have not yet clarified if one protocol of treatment is superior to others. At the present time a number of treatments for displaced three- and four-part proximal humeral fractures are available, everyone with limits and advantages. The most employed are conservative treatment, reduction and fixation, and shoulder prosthesis. Having these premises in mind, it is essential to be able to correctly diagnose the type of fracture, to examine the vascular support and the level of head necrosis risk, to predict the advantages that the patient can take of the different treatments, and finally to indicate the best one. Open reduction and internal fixation of three- and four-part fractures by plate and screws will be described in this chapter.

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Author information

Authors and Affiliations

  1. Shoulder and Elbow Surgical Unit, Rizzoli Orthopaedic Institute, Via G.C. Pupilli, nr 1, Bologna, 40136, Italy

    Enrico Guerra, Daniele Fabbri, Graziano Bettelli, Alessandro Marinelli, Michele Cavaciocchi & Roberto Rotini

Authors
  1. Enrico Guerra
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  2. Daniele Fabbri
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  3. Graziano Bettelli
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  4. Alessandro Marinelli
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  5. Michele Cavaciocchi
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  6. Roberto Rotini
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Corresponding author

Correspondence to Enrico Guerra .

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Editors and Affiliations

  1. Department of Orthopaedics and Traumatology, CTO Hospital Turin, Turin, Italy

    Filippo Castoldi

  2. Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, Turin, Italy

    Davide Blonna

  3. Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, Turin, Italy

    Marco Assom

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Guerra, E., Fabbri, D., Bettelli, G., Marinelli, A., Cavaciocchi, M., Rotini, R. (2015). ORIF in Three-/Four-Part Fractures. In: Castoldi, F., Blonna, D., Assom, M. (eds) Simple and Complex Fractures of the Humerus. Springer, Milano. https://doi.org/10.1007/978-88-470-5307-6_7

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  • DOI: https://doi.org/10.1007/978-88-470-5307-6_7

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5306-9

  • Online ISBN: 978-88-470-5307-6

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