6/29/2023 0 Comments Impacted shoulder fracture![]() ![]() Possible advantages include faster mobilization, less pain, and better functional outcome. With the advent of more advanced implants and improved surgical techniques, surgical interventions for these fractures are gaining more acceptance. However, if severe fracture dislocation is present, poor functional outcome of conservative treatment can be anticipated and surgical intervention must be considered. Up to 80 % of fractures of the proximal humerus are suitable for conservative management, with the use of a sling and physical therapy. Level of evidenceĪccording to OCEBM Working Group, Level IV. This study shows that it is safe and justifiable to consider surgical treatment of a severely dislocated proximal humerus fracture in selected patients aged 75 and older. There were no postoperative deaths within 3 months of surgery, and fracture-related and non-fracture-related complication rates were low (non-union 3 % 1 myocardial infarction). Persistent pain and ADL limitations were more present in more comminuted fractures (64 and 50 % in patients with 4-part fractures vs. Prosthetic treatment, mostly used in highly comminuted fractures, often resulted in poor function (mean DASH 72.9). Regarding the operative methods, overall good results were obtained with the modern locked plate osteosynthesis (mean DASH 34.4). ![]() Mean DASH scores were 37.5, 36.9, and 48.6, respectively. Sixty-four patients were treated surgically for a displaced proximal fracture of the humerus: 15 two-part, 32 three-part, and 17 four-part fractures. We used the DASH Questionnaire to investigate functional outcome, pain, and ADL limitations. Patient selection was on clinical grounds, based on physical, mental, and social criteria. In this observational study, we analyzed all operatively treated patients, aged 75 or older, with a proximal humerus fracture between January 2003 and December 2008 in our center. This study was performed to gain more insight in safety and functional outcome of surgical treatment of proximal humerus fractures in the elderly. Very little is known about the outcome after operative treatment of these fractures in very old patients. Over 75 % of patients presenting with a proximal humerus fracture are 70 years or older. ![]()
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