Simple and Complex Fractures of the Humerus pp 131-141 | Cite as
Surgical Neck Fracture
Abstract
Surgical neck fractures are frequent. Elderly patients with osteoporotic bone are typically affected. Conservative treatment seems to be the treatment of choice for undisplaced and minimally displaced fractures. For displaced fractures, current literature generally supports surgical treatment, but there is no consensus on the surgical technique. Functional demand, age, bone quality, fracture characteristics (type and entity of displacement, comminution), and associated lesions must be considered as a whole to define the best surgical treatment. Current literature identifies closed reduction and percutaneous pinning, locking plate fixation, and intramedullary nailing as the most suitable surgical alternatives. Angular stable intramedullary nails and plates are the most commonly used techniques, particularly suitable to younger active patients. There are very few studies comparing nails and plates for surgical neck fractures, with clinical and radiographic outcomes almost comparable between the two techniques. Minimally invasive techniques are applied with success to both implants for these fractures if a deltoid-splitting approach is performed. The role of CRPP may be limited to avoid nonunions in elderly low-demanding patients.
Keywords
Rotator Cuff Humeral Head Intramedullary Nailing Proximal Humeral Fracture Proximal FragmentReferences
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