Literature DB >> 23936736

Outcomes After Fixation of Proximal Humerus (OTA Type 11) Fractures in the Elderly Patients Using Modern Techniques.

Brandon S Shulman1, Crispin C Ong, James H Lee, Raj Karia, Joseph D Zuckerman, Kenneth A Egol.   

Abstract

PURPOSE: To investigate the effects of age on the clinical, functional, and radiographic outcomes of patients with proximal humerus fractures treated operatively with locking plates.
METHODS: Between February 2003 and July 2012, all patients who sustained a proximal humerus fracture who presented to our institution were enrolled into a database. Patients were followed up at 1, 6, 12, 26, and 52 weeks postoperatively with physical examination and radiographs. Validated functional outcomes scores were collected at 6 and 12 months. Complications were recorded as they occurred. Statistical analysis was conducted to assess for functional, physical, or radiographic differences between patients age younger than 65 and patients age 65 or older.
RESULTS: Of the 147 consecutive patients treated operatively for a proximal humerus fracture, 115 (78%) patients with an average follow-up of 16 months met the inclusion criteria for this study. The young cohort (patients < 65) included 70 patients with an average age of 53, whereas the elderly cohort (patients ≥ 65) included 45 patients with an average age of 73. The older cohort had significantly more women (P = .04), but there was no statistical difference in fracture type between the age groups. There were no differences in the radiographic measures of screw penetration, humeral head height, and neck-shaft angle between the age groups. There were no differences in physical examination scores between the age groups. There were no significant differences in functional outcomes or complication rates between the age groups.
CONCLUSION: Treating proximal humerus fractures operatively with locked plates can overcome the challenges of poor bone quality that often occur with increasing age. Age should not play a significant role in the decision-making process for treating proximal humerus fractures that would otherwise be indicated for surgical fixation.

Entities:  

Keywords:  age; elderly; locking plate; proximal humerus fracture

Year:  2013        PMID: 23936736      PMCID: PMC3739412          DOI: 10.1177/2151458513498597

Source DB:  PubMed          Journal:  Geriatr Orthop Surg Rehabil        ISSN: 2151-4585


  13 in total

1.  Effect of screw placement on fixation in the humeral head.

Authors:  A S Liew; J A Johnson; S D Patterson; G J King; D G Chess
Journal:  J Shoulder Elbow Surg       Date:  2000 Sep-Oct       Impact factor: 3.019

2.  Management of proximal humeral fractures in elderly patients with uni- or polyaxial locking osteosynthesis system.

Authors:  Hong-Fei Shi; Jin Xiong; Yi-Xin Chen; Jun-Fei Wang; Shou-Feng Wang; Zhi-Jun Chen; Yong Qiu
Journal:  Arch Orthop Trauma Surg       Date:  2010-10-21       Impact factor: 3.067

3.  Update in the epidemiology of proximal humeral fractures.

Authors:  Mika Palvanen; Pekka Kannus; Seppo Niemi; Jari Parkkari
Journal:  Clin Orthop Relat Res       Date:  2006-01       Impact factor: 4.176

4.  Fracture and dislocation compendium. Orthopaedic Trauma Association Committee for Coding and Classification.

Authors: 
Journal:  J Orthop Trauma       Date:  1996       Impact factor: 2.512

5.  Displaced proximal humeral fractures. I. Classification and evaluation.

Authors:  C S Neer
Journal:  J Bone Joint Surg Am       Date:  1970-09       Impact factor: 5.284

6.  Analysis of efficacy and failure in proximal humerus fractures treated with locking plates.

Authors:  Juan Agudelo; Matthias Schürmann; Philip Stahel; Peter Helwig; Steven J Morgan; Wolfgang Zechel; Christian Bahrs; Anand Parekh; Bruce Ziran; Allison Williams; Wade Smith
Journal:  J Orthop Trauma       Date:  2007 Nov-Dec       Impact factor: 2.512

7.  The importance of medial support in locked plating of proximal humerus fractures.

Authors:  Michael J Gardner; Yoram Weil; Joseph U Barker; Bryan T Kelly; David L Helfet; Dean G Lorich
Journal:  J Orthop Trauma       Date:  2007-03       Impact factor: 2.512

Review 8.  Biomechanics of locked plates and screws.

Authors:  Kenneth A Egol; Erik N Kubiak; Eric Fulkerson; Frederick J Kummer; Kenneth J Koval
Journal:  J Orthop Trauma       Date:  2004-09       Impact factor: 2.512

9.  Preliminary prediction model for fear-induced activity limitation after total knee arthroplasty in people 60 years and older: prospective cohort study.

Authors:  Yong-Hao Pua; Peck-Hoon Ong; Amanda Yan-Ying Lee; Jiajie Tan; Adam L Bryant; Ross A Clark
Journal:  Arch Phys Med Rehabil       Date:  2012-10-24       Impact factor: 3.966

10.  Internal fixation of proximal humeral fractures with locking proximal humeral plate (LPHP) in elderly patients with osteoporosis.

Authors:  Ramchander Siwach; Roop Singh; Rajesh Kumar Rohilla; Virender Singh Kadian; Sukhbir Singh Sangwan; Manjeet Dhanda
Journal:  J Orthop Traumatol       Date:  2008-07-16
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  4 in total

1.  Operative repair of proximal humerus fractures in septuagenarians and octogenarians: Does chronologic age matter?

Authors:  Abraham Michael Goch; Anthony Christiano; Sanjit Reddy Konda; Philipp Leucht; Kenneth Andrew Egol
Journal:  J Clin Orthop Trauma       Date:  2017-01-23

2.  Outcomes following fracture fixation with the Equinoxe® proximal humerus plate: an improvement over PHILOS®?

Authors:  Connor P Littlefield; Jack H Drake; Kenneth A Egol
Journal:  Eur J Orthop Surg Traumatol       Date:  2021-06-09

3.  The Proximal Humerus Outcome Score at One Year (POSY) Predicts Which Patients Have Poor Functional Outcomes Following Operative Fixation of Proximal Humerus Fractures.

Authors:  Nina D Fisher; Adam Driesman; Hesham Saleh; Kenneth A Egol; Sanjit R Konda
Journal:  Cureus       Date:  2022-07-07

4.  Establishing the appropriate position of proximal humerus locking plates: a cadaveric study of five plating systems and their anatomic reference measurements.

Authors:  Matthew A Butler; Aakash Chauhan; Gregory A Merrell; Jeffrey A Greenberg
Journal:  Shoulder Elbow       Date:  2017-05-23
  4 in total

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