Proximal Humerus Surgery


Eight patients had osteosarcomas, four chondrosarcomas, two giant cell tumors, two chondroblastomas of the proximal humerus and one a metastasis from thyroid cancer in the proximal humerus. Kannus and colleagues [1] re-ported an incidence of 40 proximal humerus frac-tures per 100,000 patients older than 60 years of age. Arthroplasty. Proximal humerus fracture is a serious injury to the humerus bone in the shoulder joint. Proximal Humeral Fracture Post-Surgical Rehabilitation Protocol (OPEN REDUCTION / INTERNAL FIXATION) General Principles: 1. Their average age at surgery was 29 years (range, 12-65 years). 0-8 WEEKS:. Periodic X-rays will be obtained to be sure the fracture is healing. One so severe that she had to have shoulder surgery as part of the recovery process. Surgery Proximal humerus fractures may need surgery. Because of my arm being swollen way too much, I had an emergency surgery in Italy (I'm from Germany), but had it fixed with a different kind of osteosynthesis. During this procedure they found another clot and bleeder to repair of artery repaired before. This will improve over the next several days. Proximal humerus fractures include fractures involving the proximal humeral physis and metaphysis. Shoulder arthroplasty for proximal humerus fractures 2. Broken bones hurt. PROXIMAL HUMERUS FRACTURE (NON-OPERATIVE) PHASE I (1-3 WEEKS) DATES: Appointments No PT for 3 weeks, unless otherwise specified by MD Rehabilitation Goals • Modalities to control pain and swelling • Protect fracture site • Maintain ROM in surrounding joints • Prevent deconditioning. With plate fixation of a proximal humeral fracture complications are rare, but include a risk of infection, damage to nearby nerves/blood vessels and delayed or non-healing of the break despite surgery. If your provider makes the assessment that the fracture will NOT heal and give you good shoulder function without surgery, surgical treatment will be recommended. com 350 surryse road, suite 100 lake zurich, il 60047. Surgery is man-datory in less than 1% of fractures, and the indications for surgery in the other two categories are relative rather than absolute. Temporary Plate Fixation The plate can be temporary fixed to the bone with ∅1. jurek the office patient info surgery forms blog. The choice of the technique depends on the status of the soft-tissues at the end of the resection. ORIF stands for Open Reduction Internal Fixation. A proximal humerus fracture is when the top part of the upper arm is broken. This surgical procedure repairs a break in the proximal end of the humerus. The pain when I move it is unbearable. 1 Preoperative evaluation Adequate preoperative evaluation is critical in the management of patients with displaced proximal humerus fractures. Many can be treated without surgery, but the most severely displaced, multi-fragmentary fractures may require operative management. 6mm K-wire through the proximal cannulated fixation screw of the targeting device (Fig. The outcomes of these fractures are frequently disappointing and previous systematic reviews are unable to guide clinical practice. the ‘rotator cuff tendons’ that attach to this area of the bone. Preoperative evaluation demonstrated a fracture of the proximal humerus with an anterior dislocation. Most of these fractures can be treated with a sling, a swathe, and early mobilization. However, start slow with clear liquids and gradually work your way back to your normal diet. To assess the vascular status of the humeral. I was a little apprehensive as I still had some PTSD from the original surgery and recovery, so I was really scared that I was going to be miserable again. Surgery involves either closed reduction with percutaneous fixation, open reduction and internal fixation, or proximal humeral head replacement. Keywords: proximal humerus nonunions, fibular strut allograft, locked plating, fixed-angle plate | HISTORICAL PERSPECTIVE Proximal humerus fractures are relatively common. The blood supply to the proximal humerus is a little unique, and that’s where the treatment options vary. If the fracture has caused part of the humerus to shift, the bone is realigned. Most proximal humerus fractures occur in people older than 65, and about half of the fractures are displaced, meaning that the two ends of the bones are separated from each other. The humerus is your upper arm bone between your shoulder and elbow. org rotator cuff insertion onto the greater tuberosity. A proximal humerus fracture is a common injury to the shoulder. A broken humerus takes around 6 weeks to heal, although it can take up to 1 year to recover after treatment. A humerus shaft fracture, on the other hand, is one that is localized at the mid portion of the upper arm. ORIF Surgery for Proximal Humerus Fracture Osteoarthritis of the Shoulder Proximal Humerus Fracture (Broken Shoulder) Reverse Total Shoulder Replacement Rheumatoid Arthritis (RA) of the Shoulder Rotator Cuff Injuries Rotator Cuff Tears Shoulder Dislocations Shoulder Impingement Syndrome Shoulder Impingement Surgery Shoulder Separation SLAP Tear. 5 Fractures and tendon injuries of the athletic shoulder. com 350 surryse road, suite 100 lake zurich, il 60047. T2 Proximal Humeral Nail is intended to provide temporary stabilization of various types of fractures, malunions and nonunions of the humerus. the ‘rotator cuff tendons’ that attach to this area of the bone. Surgery Proximal humerus fractures may need surgery. We also report on complications, readmissions, in-hospital mortality, and need for surgery after initial treatment of proximal humeral fractures in California, Florida, and New York. A proximal humeral fracture is a broken bone that occurs near your shoulder joint. Unlike other benign lesions, GCT can metastasize to a distant site such as the lungs, but this is rare. This surgical procedure repairs a break in the proximal end of the humerus. Ryan, and Peter L. Fractures involving the attachments of the rotator cuff. With plate fixation of a proximal humeral fracture complications are rare, but include a risk of infection, damage to nearby nerves/blood vessels and delayed or non-healing of the break despite surgery. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. In general, 98-99% of all proximal humerus fractures can be managed without an operation. Compression forces acting on the humerus tend to affect the proximal or distal portions, but spare the diaphysis. In a young person, this kind of a break can happen after a severe trauma to the shoulder. It is performed for some low-grade tumors and, rarely, for high-grade tumors of the prox-imal humerus that have no extraosseous component (Stage IIA). What was done here was a Closed Manipulative Reduction of a Closed Fracture of the Proximal Humerus with Percutaneous Pin Fixation, with X-ray imaging of the fracture reduction and the placement of the pin fixation. Fractured Shoulder (Proximal Humerus) What has happened? You have fractured (broken) the top of your arm bone near the shoulder joint What should I expect? Most of these fractures are treated with a special type of sling called a collar and cuff, followed by physiotherapy, and do not usually require surgery What should I do?. If your provider makes the assessment that the fracture will NOT heal and give you good shoulder function without surgery, surgical treatment will be recommended. Here we look at the typical causes, symptoms, diagnosis, treatment and recovery process for upper arm fractures. Three-part proximal humeral fractures (five case series, n=101 patients): One case series showed that nine patients treated with buttress plating had the highest Neer and pain scores. • The top part of the elbow joint. A proximal humerus fracture occurs in the upper arm bone near the shoulder joint. Surgeons are especially likely to opt for wires over other forms of fixation when they need to protect the repair of a concomitant neurovascular injury, or in cases in which the patient cannot tolerate a more invasive surgery. There truly is not a consensus on best practices for treatment of proximal humerus fractures [55, 56]. External rotation osteotomy of the proximal humerus is indicated for correction of internal rotation deformity secondary to brachial plexus lesion. 0-8 WEEKS:. Proximal humerus fractures account for 5% of all fractures of the appendicular skeleton. Read "Complex proximal humerus fractures: Hertel’s criteria reliability to predict head necrosis, MUSCULOSKELETAL SURGERY" on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. If the fractured segment lies inside the joint then fracture is known as intraarticular fracture and if the fracture segment lies outside the joint or joint capsule then fracture is known as extra-articular fracture. , April 23, 2014 /PRNewswire-iReach/ -- The new Acumed Polarus 3 Solution incorporates both plate and nail implants into a single system for the surgical repair of Proximal Humerus Fracture s. Proximal Humerus Fractures: Fractures of the upper part of the arm are more common in the older (over 65 years of age) population. 23616 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement $7,886. Fractures involving the proximal humeral physis are categorized by the Salter Harris classification system and fractures of the metaphysis are described by the amount of angulation and displacement at the fracture site. Guy in my physio group spent 6 months on morphine because of his pain after the op. Goal: Maintain range of motion (ROM) without displacing the proximal humerus fracture. These fractures tend to occur in older patients who are osteoporotic. Most proximal humeral fractures are nondisplaced or minimally displaced. The Sleeve System – Screw holes are accessible by sleeve system for percutaneous screw on erti sn i – Outer sleeves snap into the aiming arm for quick assembly and removal – Different drill sleeves for the option of locking and cortex screw insertion – Color-coding facilitates system. Different kinds. At this point, a 13-hole PERI-LOC™ Proximal Humerus Plate was applied to the humerus (Figure 3). Indications. Surgical Exposures of the Humerus Location Procedure Clinical Example Surgical Approach Concerns and Limitations Proximal Total shoulder arthroplasty Conventional or reverse prosthesis Deltopectoral Axillary nerve, anterior humeral circumflex artery ORIF of the proximal humerus Three- or four-part fractures requiring open reduction. ORIF stands for Open Reduction Internal Fixation. If the fragments are shifted out of position, surgery is usually required. The “ball” is the head of the humerus. A proximal humeral fracture can be a painful injury that limits your ability to move your arm and shoulder. We have therefore devised guidelines which outline the goals patients should be aiming to achieve during their rehabilitation. Other recognized mechanisms of injury were a direct impact to the proximal humerus or a fall with the. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. Ongoing pain and stiffness was attributed to a screw protruding through the humeral articular surface (confirmed on shoulder arthroscopy). Therefore, it is the author ’s preference to per form an extraarticular resection for high-grade sarcomas of the proximal humerus (Type V resection). ORIF stands for Open Reduction Internal Fixation. Antti Launonen and team assess surgery compared with locking plate and non-operative treatment for displaced two-part proximal humerus fractures in a superiority, assessor-blinded, randomized trial in six hospitals in Finland, Estonia, Sweden, and Denmark. The objective of this study was to investigate the national surgical trends in elderly patients with proximal humeral fractures in South Korea. Soft tissue refer to the muscles, ligaments, nerves, tendons and blood vessels, joint cartilage, etc. open treatment of proximal humeral (surgical or anatomical neck) fracture, with or without internal or external fixation, with or without repai 23616 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, WITH OR W/O INTERNAL/EXTERNAL FIXATION, WITH OR W/O REPAIR OF TUBERO. I'm very concerned about one issue though. In many cases, proximal and mid-shaft humerus fractures don't require surgery because the broken ends usually stay close together. Although increasingly used, the benefit of surgical treatment of displaced 2-part proximal humerus fractures has not been proven. 2019 The results of a recent Nordic collaboration study showed that there is no difference in functional results between operative and non-operative treatment in persons aged 60 or more with displaced proximal humerus fractures. 0388 f : 847. A proximal humerus fracture is a serious injury to the humerus bone in the shoulder joint that requires immediate treatment to preserve function of the shoulder. (c) The lateral and long heads of the triceps muscle are separated from the caudal border of the humerus and the brachialis muscle. Through an integrated knowledge user. Most lesions can be followed conservatively, but surgical resection may alleviate pain, avoid pathological fractures, and prevent transformation into higher grade chondrosarcomas. Proximal Humerus (Upper Arm) Fractures: A Guide to Recovery After Surgery www. jurek the office patient info surgery forms blog. The process takes several months. The proximal humerus refers to the upper part of the bone that makes up the ball component of the shoulder's ball and socket joint. Medial calcar (arrows) of the proximal humerus is the portion of the humeral shaft just below the inferior limit of the anatomic neck. "Proximal" refers to being close to your body, and "humeral" refers to the arm bone known as the humerus. options in ORIF for proximal humeral fracture in patients with PD. ORIF Surgery for Proximal Humerus Fracture is when the bone fragments of the proximal humerus are shifted out of place surgery is typically required. Certain proximal humerus fractures can be treated without surgery. The commonest primary tumor to metastasize was breast, and the proximal and midshaft humerus was involved in 84% of cases. STABLE PROXIMAL HUMERUS FRACTURE REHAB PROTOCOL Introduction This protocol is for patients with nondisplaced proximal humerus fractures, or patients with proximal humerus fractures that have been surgically repaired. ORIF stands for Open Reduction Internal Fixation. ASSOCIATEPROFESSOR SHOULDER AND ELBOW SURGERY UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER SAN ANTONIO DISCLOSURE • consultant for Wright Medical Displacement > 1 cm Angulation > 45 degree ALTERNATIVEDESCRIPTIONS Five Part Theory Mittlmeier et al, 2003 Binary Description. Physical Therapy in Corpus Christi for Shoulder. Proximal humerus fracture is a serious injury to the humerus bone in the shoulder joint. Kids usually break their arm after falling off the monkeybars or after falling onto an outstretched arm. A proximal humerus fracture is when the bone is broken at or near the top, by the shoulder. The humerus goes from the shoulder joint to the elbow joint and must be strong enough to take a good deal of weight when you lift something or push against something. The vast majority of patients with proximal humerus fractures do not require long-term follow-up Fractures that involved the physis rarely result in a growth arrest and, as such, do not routinely require long term follow-up. Computational assessments of implant impingement have. Closed treatment proximal humeral fracture A humerus fracture can be classified by the location of the humerus involved: the upper end, the shaft, or the lower end. Fractured Shoulder (Proximal Humerus) What has happened? You have fractured (broken) the top of your arm bone near the shoulder joint What should I expect? Most of these fractures are treated with a special type of sling called a collar and cuff, followed by physiotherapy, and do not usually require surgery What should I do?. Jeremy Sherman, PT, MPT. 23615 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; 23616 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes. We will take X-rays a couple of weeks after your injury, then get the shoulder moving to avoid stiffness of the shoulder joint. The proximal humerus is one of the bones in your shoulder joint. lakecookortho. The humerus is the long bone that sits between the shoulder and the elbow. The appropriate radiographs of the proximal humeral fracture are analyzed in conjunction with radiographs of the opposite side. 5 weeks post-fracture (rt closed proximal humerus) with the same symptoms/concerns. A proximal humerus fracture is when the top part of the upper arm is broken. Our e-learning platform contains high resolution images and a certified CME of the Lima SMR Reverse Total Shoulder Replacement for proximal humeral fracture surgical procedure. ASSOCIATEPROFESSOR SHOULDER AND ELBOW SURGERY UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER SAN ANTONIO DISCLOSURE • consultant for Wright Medical Displacement > 1 cm Angulation > 45 degree ALTERNATIVEDESCRIPTIONS Five Part Theory Mittlmeier et al, 2003 Binary Description. jurek the office patient info surgery forms blog. Shoulder and Elbow & Upper Extremity Surgery Resurgens Orthopaedics Emory University Midtown Hospital Emory St. For severe proximal humerus fractures, a shoulder replacement surgery is used to remove the damaged bone and insert an artificial implant. Clinical Relevance: Knowledge of the quantitative anatomy of the tendons of the proximal humerus and axillary nerve can aid in identifying structures of interest during open shoulder surgery and in avoiding iatrogenic axillary. Proximal humeral fractures are proximal to the surgical neck (see figure Key anatomic landmarks in the proximal humerus). Hardware Removal - Best Decision EVER! I had the hardware removed on November 22nd, 2013. Thus, this study aimed to investigate Brazilian orthopedic surgeons' choice of approach for osteosynthesis. Advances in adjuvant therapies and reconstructive. Non-operative treatment of displaced proximal humerus fractures yields corresponding results to surgery 19. Compression forces acting on the humerus tend to affect the proximal or distal portions, but spare the diaphysis. Proximal Humeral Replacement As surgery for sarcoma is individual for each patient, rehabilitation will be tailored to each patient accordingly. The (anterior) deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the preferred approach. Goal: Maintain range of motion (ROM) without displacing the proximal humerus fracture. Orthosports is a professional association of Orthopaedic surgeons in Sydney. Increase ROM while protecting the fracture site (you can be slightly more. Sort by: Bone Defect Glenoid Fractures Glenoid Microfracture Greater Tuberosity Fracture HAGL Hemiarthroplasty History of Shoulder Surgery. First, how is the union of the humerus going? You are now about 7 - 8 weeks out. Temporary Plate Fixation The plate can be temporary fixed to the bone with ∅1. The humerus is the bone of the upper arm. An x-ray revealed that my left humerus was badly fractured (spiral) in four places and the doctors said surgery would be needed as soon as possible. Kannus and colleagues [1] re-ported an incidence of 40 proximal humerus frac-tures per 100,000 patients older than 60 years of age. The HSS Orthopedic Trauma Service has conducted many studies. Non-operative treatment of displaced proximal humerus fractures yields corresponding results to surgery 19. The plate was held proximally with Kirschner wires through the small holes in the plate. Of these, supracondylar fractures are the most common followed by lateral humeral condylar fractures. A proximal humerus fracture occurs in the upper arm bone near the shoulder joint. A substantial number of patients, old and young, who sustain a proximal humeral fracture are managed with Kirschner wires (K-wires). A fractured neck of humerus is a common injury of the upper limb. What is proximal humerus fractures? The shoulder joint comprises three bones, scapula (shoulder blade), clavicle (collar bone) and humerus (upper arm bone) in a socket named as the glenoid cavity. It is a type of humerus fracture. Surgical treatments that range from relatively simple to more complex may be considered depending on the fracture pattern. Slips, Trips, And Falls. Jack Kazanjian, DO, FAOAO, Clin. options in ORIF for proximal humeral fracture in patients with PD. First, how is the union of the humerus going? You are now about 7 - 8 weeks out. Why do some proximal humerus fractures require surgery? The proximal humerus is part of the shoulder joint, and it also is the attachment of the important rotator cuff muscles. Goal: Maintain range of motion (ROM) without displacing the proximal humerus fracture. PROXIMAL HUMERUS FRACTURE (NON-OPERATIVE) PHASE I (1-3 WEEKS) DATES: Appointments No PT for 3 weeks, unless otherwise specified by MD Rehabilitation Goals • Modalities to control pain and swelling • Protect fracture site • Maintain ROM in surrounding joints • Prevent deconditioning. If the fractured segment lies inside the joint then fracture is known as intraarticular fracture and if the fracture segment lies outside the joint or joint capsule then fracture is known as extra-articular fracture. A Synthes locking plate was used to secure the bone fragments in proper anatomic alignment for optimal healing. 1 month later still taking 10/325 Percocet every 4 hours and I am in excruciating pain at certain times. Here we look at the typical causes, symptoms, diagnosis, treatment and recovery process for upper arm fractures. Pain is the body’s natural response when a bone breaks. An x-ray revealed that my left humerus was badly fractured (spiral) in four places and the doctors said surgery would be needed as soon as possible. jurek the office patient info surgery forms blog. 110) A 69-year-old woman falls while getting out of her car and lands on her right shoulder sustaining a 4-part proximal humerus fracture. open treatment of proximal humeral (surgical or anatomical neck) fracture, with or without internal or external fixation, with or without repai 23616 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, WITH OR W/O INTERNAL/EXTERNAL FIXATION, WITH OR W/O REPAIR OF TUBERO. Indications. If your provider makes the assessment that the fracture will NOT heal and give you good shoulder function without surgery, surgical treatment will be recommended. PROXIMAL HUMERUS FRACTURE - ORIF PHASE I (1-3 WEEKS) DATES: Appointments • Begin physical therapy at 1 week post op, 2 x/week • Follow up with MD 10-14 days post op. Rudzki, MD, MSc Washington Orthopaedics & Sports Medicine Clinical Assistant Professor Dept. Ideally, surgeons like to perform surgery within 1-2 weeks of injury. This surgical procedure repairs a break in the proximal end of the humerus. Proximal Humerus Fracture using Locked Plating VuMedi flv Humerus Fractures Anterior Approach Total Hip Replacement Surgery - Duration:. proximal humerus is at a much higher risk for local recurrence following an intraarticular resection when compared to the local recurrence rate of other major joints. The pain when I move it is unbearable. ORIF stands for Open Reduction Internal Fixation. The HSS Orthopedic Trauma Service has conducted many studies. Proximal humerus fractures are just one type of shoulder injury - you can find out more in the shoulder fractures section. Patients with a distal humerus fracture present with pain and swelling of the distal arm and elbow. The Sleeve System – Screw holes are accessible by sleeve system for percutaneous screw on erti sn i – Outer sleeves snap into the aiming arm for quick assembly and removal – Different drill sleeves for the option of locking and cortex screw insertion – Color-coding facilitates system. Greater tuberosity fractures are less common and are seen in cases of shoulder dislocations and in those with osteoporosis. In general, 98-99% of all proximal humerus fractures can be managed without an operation. Most of these fractures can be treated with a sling, a swathe, and early mobilization. You will have some sharp pains in this area because of this. Indications for treating these fractures conservatively, with surgical fixation or arthroplasty are continually evolving and are based on the severity of the fracture and the age of the patient. the proximal humerus using an inlay fibular strut allograft, compression through the nonunion site with heavy suture, and secure fixation with a fixed-angle locked plate. Humerus IM Rodding and ORIF Some fractures that occur along the shaft of the humerus bone can be treated with conservative treatment that includes a fracture arm brace and/or cast. Proximal Humerus Fracture I was a little apprehensive as I still had some PTSD from the original surgery and recovery, so I was really scared that I was going to. Thank you Gaelic, I'm 14 an had surgery 4 weeks ago for a proximal humerus fracture. This surgical procedure repairs the break in proximal end of the humerus by using an ORIF (open reduction internal fixation). A proximal humerus fracture usually occurs close to the shoulder joint and can be located at different levels with different fracture patterns: simple or comminuted. Proximal humerus fractures may need surgery. A proximal humerus fracture, also called a broken shoulder, is a common injury affecting the upper part of the arm which forms the rounded ‘ball’ section. The findings of the present study are clinically relevant, as life expectancy continues to increase and the Medicare population continues to grow. While many fractures involving the proximal humerus can tolerate displacement, the greater tuberosity, due to the attachment of the rotator cuff, cannot. Intended Use The AxSOS 3 Titanium Locking Plate System is intended for long bone fracture. These patients have lost the power of external rotation and hence have developed an internal rotation contracture. 5 Fractures and tendon injuries of the athletic shoulder. Arthroplasty for proximal humerus fractures is a good surgical option for low-demand elderly patients, or fractures that are not amenable to ORIF. Keywords: proximal humerus nonunions, fibular strut allograft, locked plating, fixed-angle plate | HISTORICAL PERSPECTIVE Proximal humerus fractures are relatively common. We present a novel, arthroscopic technique to treat intraosseous ganglion lesions of the proximal humerus. Proximal humerus fracture is a serious injury to the humerus bone in the shoulder joint. The proximal humerus replacement components are: •oximal humeral bodies Pr •ntercalary segments (if required) I •umeral stems H •issue attachment augments (if required) T. A recent meta-analysis concluded that plate fixation was associated with a higher rate of avascular necrosis than conservative management. Of these, supracondylar fractures are the most common followed by lateral humeral condylar fractures. Executive Editor: Peter Trafton Authors: Martin Jaeger, Frankie Leung, Wilson Li Proximal humerus Extraarticular 3-part, surgical neck and tuberosity, no impaction Search 1 Principles top Introduction Hemiarthroplasty is indicated in all cases where a stable osteosynthesis is not achievable especially in situations with poor bone quality like severe osteoporosisCertainly it is wise to use. Proximal humeral fractures are proximal to the surgical neck (see figure Key anatomic landmarks in the proximal humerus). The humerus is your upper arm bone between your shoulder and elbow. This is an enhanced PDF from The Journal of Bone and Joint Surgery J Bone Joint Surg Am. If your provider makes the assessment that the fracture will NOT heal and give you good shoulder function without surgery, surgical treatment will be recommended. The T2 Proximal Humeral Nail is designed to be inserted either through a lateral (A) or a central (B) entry point (Fig. Indications for treating these fractures conservatively, with surgical fixation or arthroplasty are continually evolving and are based on the severity of the fracture and the age of the patient. Proximal humerus fracture—If your fracture is near the shoulder joint (where the humerus connects with the scapula), then you have a proximal humerus fracture. Shoulder arthroplasty for fracture: restoration of the “gothic arch”. hi, i fractured my proximal humerus 3 weeks ago, body surfing in india, first day spent in absolute agony without pain relief, then taken for surgery to have it plated, with ten pins. In adults, the fracture often involves the joint, which needs to be anatomically aligned. Proximal humerus fractures can be fixed with plates and screws or joint replacement depending on the type of injury. Types of fractures include, but not limited to fractures of the humeral shaft, non-unions, malalignments, pathological humeral fractures, and impending pathological fractures. Certain proximal humerus fractures can be treated without surgery. Classification is based on the four-part anatomy of the proximal humerus humeral head; lesser tuberosity. This surgical procedure repairs a break in the proximal end of the humerus. PROFHER Study hypothesis. Fixation of the Proximal Humerus Our orthopaedic shoulder surgeons are all fellowship trained and specialize specifically in shoulder surgery. The humerus is the long bone that sits between the shoulder and the elbow. Hardware Removal - Best Decision EVER! I had the hardware removed on November 22nd, 2013. This is a common fracture that occurs after direct trauma followig a fall. Proximal Humerus Fractures. The approximate location of the original humeral shaft medial calcar is. Rehabilitation therapy, as described above, begins as soon as possible. A proximal humerus fracture is a fracture to top of the humerus bone, either at or just below the humeral head. Increase ROM while protecting the fracture site (you can be slightly more. Comminuted fractures as seen on case one, requiere full replacement of the humeral proximal third. It is known that there are large regional variations in treatment methods for the management of proximal humeral fractures. Closed treatment proximal humeral fracture A humerus fracture can be classified by the location of the humerus involved: the upper end, the shaft, or the lower end. The proximal humerus is the top of the arm bone, and blood supply is unique in that area of the body, so shoulder surgery is not always the best option for every patient. Plate and screw fixation is used for most proximal humerus fixations. Proximal humerus fractures occur through a range of mechanisms such as a direct blow to the shoulder, a fall to the side, a fall on the outstretched arm and an impact during motor vehicle accidents. InfoSheet - Proximal Humerus Fractures David M. Guy in my physio group spent 6 months on morphine because of his pain after the op. A proximal humerus fracture is sometimes referred to as a a broken shoulder or a broken arm. It usually takes about 6 to 8 weeks for a proximal humerus fracture to unite. Surgical Exposures of the Humerus Location Procedure Clinical Example Surgical Approach Concerns and Limitations Proximal Total shoulder arthroplasty Conventional or reverse prosthesis Deltopectoral Axillary nerve, anterior humeral circumflex artery ORIF of the proximal humerus Three- or four-part fractures requiring open reduction. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. Pre operative planning in the form of appropriate clinical evaluation, CT scan or other imaging techniques and keeping all options open during surgery is useful. , April 23, 2014 /PRNewswire-iReach/ -- The new Acumed Polarus 3 Solution incorporates both plate and nail implants into a single system for the surgical repair of Proximal Humerus Fracture s. open treatment of proximal humeral (surgical or anatomical neck) fracture, with or without internal or external fixation, with or without repai 23616 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, WITH OR W/O INTERNAL/EXTERNAL FIXATION, WITH OR W/O REPAIR OF TUBERO. The amount of impaction and loss of reduction in osteoporotic proximal humeral fractures after surgery More than 90% of proximal humerus fractures affect the elderly. Rehabilitation Goals • Protect repair • Minimize pain and swelling • Maintain ROM of surrounding joints • Prevent adhesive capsulitis. Surgical Exposures of the Humerus Location Procedure Clinical Example Surgical Approach Concerns and Limitations Proximal Total shoulder arthroplasty Conventional or reverse prosthesis Deltopectoral Axillary nerve, anterior humeral circumflex artery ORIF of the proximal humerus Three- or four-part fractures requiring open reduction. PROXIMAL HUMERUS FRACTURE - ORIF PHASE I (1-3 WEEKS) DATES: Appointments • Begin physical therapy at 1 week post op, 2 x/week • Follow up with MD 10-14 days post op. This surgical procedure repairs a break in the proximal end of the humerus. Post Fracture Proximal Humerus Rehabilitation Guidelines R / L Humerus Fracture: _____ Standard Course Patients will typically follow a standard post-fracture rehab course if their fracture is: Non Displaced 2 Part Fracture Good Alignment Does not involve an articular surface. The implants are intended as a guide to normal healing and are NOT. There truly is not a consensus on best practices for treatment of proximal humerus fractures [55, 56]. How Do Proximal humerus fractures occur?. One so severe that she had to have shoulder surgery as part of the recovery process. Insert Tocar Sleeves Insert the NCB tissue protection sleeve assembly∅1. Fractures may occur at any of the bones which constitute the shoulder, but the clavicle (collarbone) is the most commonly injured. The information given in this section is a general guide and individual cases should be discussed with your rehabilitation team. If your provider makes the assessment that the fracture will NOT heal and give you good shoulder function without surgery, surgical treatment will be recommended. The proximal humerus is part of the shoulder joint, and the distal humerus is part of the. The surgical procedure will repair the break in the proximal end of the humerus. Epidemiology Proximal humeral fractures represent around 5% of all fractures ?. Computational assessments of implant impingement have. If you are looking for exercises to do following a proximal shoulder fracture, whether you need surgery or not, visit the shoulder exercises section. Surgical treatments that range from relatively simple to more complex may be considered depending on the fracture pattern. Proximal humerus fractures occur through a range of mechanisms such as a direct blow to the shoulder, a fall to the side, a fall on the outstretched arm and an impact during motor vehicle accidents. Broken Humerus, recovery time? The advantage of no surgery is no / less muscle damage from fitting the mechano to hold it together. proximal humerus fracture orif postop protocol. Proximal Humeral Epiphysiolysis (Little Leaguer’s Shoulder) Little Leaguers’ Shoulder is a term that is used to describe pains and discomforts that pitchers and other overhead athletes have in their shoulder when the growth plate in the upper arm (humerus) is injured. Greater tuberosity fractures are less common and are seen in cases of shoulder dislocations and in those with osteoporosis. We have unique expertise in fixations of the proximal humerus and perform many of these procedures each year. A proximal humerus fracture is a fracture to top of the humerus bone, either at or just below the humeral head. ORIF Proximal Humerus Rehabilitation Program Instructions: Don't lift anything heavier than a cup of coffee for the first 6 weeks after surgery. shoulder surgery + sports medicine. In many cases, proximal and mid-shaft humerus fractures don’t require surgery because the broken ends usually stay close together. If your provider makes the assessment that the fracture will NOT heal and give you good shoulder function without surgery, surgical treatment will be recommended. A proximal humerus fracture is a serious injury to the humerus bone in the shoulder joint that requires immediate treatment to preserve function of the shoulder. Welcome to Humpal Physical Therapy & Sports Medicine Centers guide to adult humerus fractures. 23615 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; 23616 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes. Humerus connecting part for longer reconstructions allowing for easier subsequent conversion to total humerus (80mm) Humerus extension piece glenoid (fixed with a range of 4. It is the third most common fracture that occurs in individuals over the age of 65, after. One so severe that she had to have shoulder surgery as part of the recovery process. Orthosports provides information and Shoulder services related to Shoulder operations or Shoulder conditions, including Proximal Humeral Fractures. In 1970, Charles Neer described his four-segment classification system. Radiographs at 4 months illustrating a healed proximal humerus fracture in excellent alignment. We have used this technique in seventeen patients (seven female and ten male). It is more common in osteoporotic bone which occurs as you get older. Surgical treatments that range from relatively simple to more complex may be considered depending on the fracture pattern. You will have some sharp pains in this area because of this. The metaphyseal region of the proximal humerus is an area prone to fracture when the bone is weakened or osteoporotic, for example, in young dogs and cats with nutritional secondary hyperparathyroidism or in older animals when the bone has been weakened by neoplasia. Return to normal function and motion may require 3 to 4 months Overall Goals: 1. A proximal humerus fracture is a break in the long bone of the upper arm at the shoulder joint. The Neer classification system helps to guide treatment of these fractures. The Acumed Polarus PHP System, designed for 2-, 3-, and 4-part proximal humerus fractures, aids in restoring patient anatomy while providing a rigid construct within the humeral head. Greater tuberosity fractures are less common and are seen in cases of shoulder dislocations and in those with osteoporosis. Surgery typically involves fixing of the fracture with plates and screws or rods inside the bone. A number of classification systems exist. The process takes several months. Eight patients had osteosarcomas, four chondrosarcomas, two giant cell tumors, two chondroblastomas of the proximal humerus and one a metastasis from thyroid cancer in the proximal humerus. Humeral fractures can be classified into three types, depending on which part of the bone is broken. Choudur, Anthony G. A proximal humerus fracture is a serious injury to the humerus bone in the shoulder joint that requires immediate treatment to preserve function of the shoulder. Radial nerve injuries associated with humeral fractures. This injury occurs right where the arm bone (humerus) connects with the shoulder blade (scapula) to form the shoulder joint. The Acumed Polarus 3 Solution is a comprehensive system designed to treat proximal and midshaft humerus fractures with an array of plate and nail options. What is open reduction and internal fixation for an arm fracture? Open reduction and internal fixation (ORIF) is a type of surgery used to stabilize and heal a broken bone. Classification is based on the four-part anatomy of the proximal humerus humeral head; lesser tuberosity. Indications. Proximal Humerus Fracture Post-Operative ORIF Jason Dieterle, DO CONSIDERATIONS: Most unstable/displaced fractures or fractures with accompanying vascular insult require surgical intervention. A proximal humerus fracture is a type of broken shoulder – it’s a fracture of the bone that connects your shoulder to your elbow. Fractures of the proximal humerus occur near the shoulder joint. PROFHER Study hypothesis. This is known as the humeral head. The humerus bone is softest at the ends, and most commonly breaks near the shoulder (called a proximal humerus fracture) or near the elbow (called a supracondylar elbow fracture).