Abstract
Proximal humeral fractures are the third most common fragility fracture and it account for 5–9% of all fractures [1, 2]. Proximal humerus fractures have a dual age distribution occurs either young people following high energy trauma or in those older than 50 years with low velocity injuries like simple fall [3]. In the elderly population, most of these fractures are related to osteoporosis [1, 3]. They have a bimodal age distribution. Proximal humeral fractures are the third most common fracture in elderly patients and pose an important socioeconomic problem [4]. More than 70% of the patients with these fractures are older than 60 years of age, and 80% are women [3, 5]. Complex three- and four part fractures account for >50% of cases in patients older than 60 years [6].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Karataglis D, Stavridis SI, Petsatodis G, Papadopoulos P, Christodoulou A. New trends in fixation of proximal humeral fractures: a review. Injury. 2011;42(4):330–8. doi:10.1016/j.injury.2010.10.016.
Rabi S, Evaniew N, Sprague SA, Bhandari M, Slobogean GP. Operative vs non-operative management of displaced proximal humeral fractures in the elderly: a systematic review and meta-analysis of randomized controlled trials. World J Orthop. 2015;6(10):838–46.
Banik II R, Mondal S. Evaluation of internal fixation with locking proximal humerus plate in osteoporotic proximal humeral fractures. IOSR-JDMS. 2015;14(1):12–9.
Helmy N, Hintermann B. New trends in the treatment of proximal humerus fractures. Clin Orthop Relat Res. 2006;442:100–8.
Maier D, Jaeger M, Izadpanah K, Strohm PC, Suedkamp NP. Proximal humeral fracture treatment in adult. J Bone Joint Surg Am. 2014;96(3):251–61.
Wong J, Newman JM, Gruson KI. Outcomes of intramedullary nailing for acute proximal humerus fractures: a systematic review. J Orthop Traumatol. 2016;17(2):113–22.
Calvo E, de Miguel I, de la Cruz JJ, López-Martín N. Percutaneous fixation of displaced proximal humeral fractures: Indications based on the correlation between clinical and radiographic results. J Shoulder Elb Surg. 2007;16(6):774–81.
Khmelnitskaya E, Lamont LE, Taylor SA, Lorich DG, Dines DM, Dines JS. Evaluation and management of proximal humerus fractures. Adv Orthop. 2012;2012:861598.
Hettrich CM, Boraiah S, Dyke JP, Neviaser A, Helfet AD, Lorich DG. Quantitative assessment of the vascularity of the proximal part of the humerus. J Bone Joint Surg Am. 2010;92(4):943–8.
Codman EA. The shoulder, rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Boston: Thomas Tood Company; 1934.
Muller M, Perren S, Allgower M. Appendix A: the comprehensive classification of fracture of long bones. In: Allgower M, editor. Manual of internal fixation: techniques recommended by the AO-ASIF Group. Berlin: Springer; 1991. p. 118–25.
Neer II CS. Four-segment classification of proximal humerus fractures: purpose and reliable use. J Shoulder Elb Surg. 2002;11(4):389–400.
Resch H, Beck E, Bayley I. Reconstruction of the valgus-impacted humeral head fracture. J Shoulder Elb Surg. 1995;4(2):73–80.
Hertel R, Hempfing A, Stiehler M, Leunig M. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elb Surg. 2004;13:427–33.
Court-Brown CM, Garg A, McQueen MM. The translated two-part fracture of the proximal humerus. Epidemiology and outcome in the older patient. J Bone Joint Surg Br. 2001;83(6):799–804.
Court-Brown CM, Cattermole H, McQueen MM. Impacted valgus fractures (B1.1) of the proximal humerus. J Bone Joint Surg Br. 2002;84(4):504–8.
Esenyel CZ, Yesiltepe Y, Bulbul M, Bagriacik A, Kara AN. Treatment of proximal humeral fractures with open reduction and internal fixation with Kirschner wires. Acta Orthop Traumatol Turc. 2001;35:10–5.
Esenyel CZ, Dedeoglu S, Imren Y, Kahraman S, Cakar M, Ozturk K. Relationship between axillary nerve and percutaneously inserted proximal humeral locking plate: a cadaver study. Acta Orthop Traumatol Turc. 2014;48(5):553–7.
Gardner MJ, Boraiah S, Helfet DL, Lorich DG. The anterolateral acromial approach for fractures of the proximal humerus. J Orthop Trauma. 2008;22(2):132–7.
Hertel R. Fractures of the proximal humerus in osteoporotic bone. Osteoporos Int. 2005;16(Suppl 2):S65–72.
Kralinger F, Unger S, Wambacher M, Smekal V, Schmoelz W. The medial periosteal hinge, a key structure in fractures of the proximal humerus: a biomechanical cadaver study of its mechanical properties. J Bone Joint Surg Br. 2009;91(7):973–6.
Burke NG, Kennedy J, Cousins G, Fitzpatrick D, Mullett H. Locking plate fixation with and without inferomedial screws for proximal humeral fractures: a biomechanical study. J Orthop Surg (Hong Kong). 2014;22(2):190–4.
Agel J, Jones CB, Sanzone AG, Camuso M, Henley MB. Treatment of proximal humeral fractures with Polarus nail fixation. J Shoulder Elb Surg. 2004;13(2):191–5.
Gradl G, Dietze A, Arndt D, Beck M, Gierer P, Börsch T, Mittlmeier T. Angular and sliding stable antegrade nailing (Targon PH) for the treatment of proximal humeral fractures. Arch Orthop Trauma Surg. 2007;127(10):937–44.
Popescu D, Fernandez-Valencia JA, Rios M, Cuñé J, Domingo A, Prat S. Internal fixation of proximal humerus fractures using the T2-proximal humeral nail. Arch Orthop Trauma Surg. 2009;129(9):1239–44.
Flatowel BLU. Location and protecting the axillary nerve in the shoulder surgery; Tug test. Orthop Rev. 1992;21:503–5.
Murachovsky J, Ikemoto RY, Nascimento LG, Milani C, Warner JJ. Pectoralis major tendon reference (PMT): a new method for accurate restoration of humeral length with hemiarthroplasty for fracture. J Shoulder Elb Surg. 2006;15(6):675–8.
Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Molé D. Tuberosity malposition and migration: Reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J Shoulder Elb Surg. 2002;11(5):401–12.
Olerud P, Ahrengart L, Ponzer S, Saving J, Tidermark J. Hemiarthroplasty versus nonoperative treatment of displaced 4-part proximal humeral fractures in elderly patients: a randomized controlled trial. J Shoulder Elb Surg. 2011;20(7):1025–33.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Esenyel, C.Z. (2017). Proximal Humerus Fractures. In: Huri, G., Paschos, N. (eds) The Shoulder. Orthopaedic Study Guide Series. Springer, Cham. https://doi.org/10.1007/978-3-319-51979-1_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-51979-1_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-51977-7
Online ISBN: 978-3-319-51979-1
eBook Packages: MedicineMedicine (R0)