Epidemiology and treatment reality of proximal humeral fractures at a level-1 trauma center View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-06

AUTHORS

J. Christoph Katthagen, Svenja Grabowski, Meret Huber, Gunnar Jensen, Christine Voigt, Helmut Lill

ABSTRACT

The treatment of proximal humeral fractures (PHF) is challenging. Recently, more restrictive displacement criteria have been introduced and the lack of treatment algorithms in the literature has been emphasized. The primary purpose of this study was to evaluate the epidemiology and treatment reality of PHF at a specialized level-1 trauma center according to current displacement criteria. The secondary aim was to assess whether a standardized treatment algorithm can be adhered to during daily clinical routine. In all, 566 patients (71.4 % female; average age, 68.1 ± 15 years) with 569 PHF were included in this retrospective cohort study. All medical records and existing x‑rays as well as computed tomography scans were analyzed. Only fractures with ad latus displacement of max 0.5 cm and/or a humeral head angulation of less than 20º were classified as nondisplaced. Patients with displaced fractures were included for evaluation of a standardized treatment algorithm. The most common fracture type was a three-part fracture (39.9 %, n = 227); 70.9 % of fractures (389/569) were displaced and therefore treated operatively. The accordance between the final operative treatment that patients received and the recommended surgical treatment on the basis of the algorithm was 90.2 % (351/389). In contrast to the rate of 15 % dislocated fractures reported by Charles Neer in 1970, more than 70 % of fractures were found to be displaced when more restrictive displacement criteria were applied. More than 90 % of displaced fractures were treated as recommended by the treatment algorithm. Fractures that fitted the least into the treatment scheme were more complex fractures of patients aged 60 years and older. More... »

PAGES

112-118

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11678-016-0362-4

DOI

http://dx.doi.org/10.1007/s11678-016-0362-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1025429711


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