You are not logged in.
Openly accessible

Severe impacted valgus proximal humerus fractures : results of operative treatment

Robinson, C. Michael and Page, Richard S. 2003, Severe impacted valgus proximal humerus fractures : results of operative treatment, Journal of bone and joint surgery, vol. 85, no. 9, pp. 1647-1655.

Attached Files
Name Description MIMEType Size Downloads
page-severelyimpacted-2003.pdf Published version application/pdf 992.29KB 161

Title Severe impacted valgus proximal humerus fractures : results of operative treatment
Author(s) Robinson, C. Michael
Page, Richard S.ORCID iD for Page, Richard S. orcid.org/0000-0002-2225-7144
Journal name Journal of bone and joint surgery
Volume number 85
Issue number 9
Start page 1647
End page 1655
Total pages 9
Publisher British Editorial Society of Bone and Joint Surgery
Place of publication London, England
Publication date 2003-09-01
ISSN 0021-9355
1535-1386
Keyword(s) impacted
valgus
fractures
nonoperative treatment
humerus
Summary Background: The functional results associated with nonoperative treatment of severely impacted valgus fractures of the proximal part of the humerus are poor, and these injuries are difficult to treat with minimally invasive percutaneous fixation techniques. The aim of this study was to review the functional and radiographic results and complications of a new operative technique in a series of twenty-five patients.

Methods: Over a two-year period, we treated twenty-nine patients with a severely impacted valgus fracture of the proximal part of the humerus. Three patients were lost to follow-up and one died, leaving twenty-five patients who were available for the study. In all of the fractures, the head-shaft angle had been tilted into =160° of valgus and the greater tuberosity was displaced by >1 cm. All patients were treated with open reduction of the fracture, and the space created behind the humeral head was filled with Norian Skeletal Repair System (SRS) bone substitute. The fractures were stabilized with either screws or buttress plate fixation. Associated rotator cuff tears were repaired. All patients underwent functional outcome assessment with use of the Constant, DASH (Disabilities of the Arm, Shoulder and Hand), and SF-36 (Short Form-36) scores at one year, and twelve patients were followed for two years.

Results: All fractures united within the first year, all reductions were maintained, and no patient had signs of osteonecrosis of the humeral head on the latest follow-up radiographs. At one year, the median Constant score was 80 points and the median DASH score was 22 points. The functional results continued to be satisfactory in the twelve patients who were followed for two years. The results in our series were better than those achieved in studies of nonoperative treatment of similar fracture configurations. There were six clinically relevant complications, although none required a reoperation and all six patients had a satisfactory short-term functional outcome.

Conclusions: Internal fixation of severely impacted valgus fractures of the proximal part of the humerus, supplemented by Norian SRS bone substitute to fill the proximal humeral metaphyseal defect, produces good early functional and radiographic outcomes. Additional follow-up will be required to assess whether these initially satisfactory outcomes are maintained over the longer term.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2003, The Journal of Bone and Joint Surgery
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30047656

Document type: Journal Article
Collections: School of Medicine
Open Access Collection
Connect to link resolver
 
Link to Related Work
 
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.

Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 0 times in TR Web of Science
Scopus Citation Count Cited 111 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 223 Abstract Views, 154 File Downloads  -  Detailed Statistics
Created: Thu, 30 Aug 2012, 09:53:06 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.