Two-part fractures and fracture dislocations.
Charles M Court-Brown1, Margaret M McQueen
1Royal Infirmary of Edinburgh, Old Dalkeith Road, Edinburgh, Scotland. courtbrown@aol.com
Hand Clinics
|December 7, 2007
Summary
Nonoperative treatment is effective for two-part proximal humeral fractures in older adults, comparable to surgical methods like plating and nailing. Further research is needed for locked plating efficacy.
Area of Science:
- Orthopedic surgery
- Traumatology
- Geriatric medicine
Background:
- Proximal humeral fractures are common, particularly in osteoporotic patients over 50.
- Two-part fractures, mainly surgical neck fractures, represent about 28% of these injuries.
Purpose of the Study:
- To discuss the management of two-part proximal humeral fractures.
- To analyze various treatment options including nonoperative, conventional plating, locked plating, antegrade nailing, retrograde pinning, and Kirschner wires.
Main Methods:
- Literature review and analysis of treatment outcomes for two-part proximal humeral fractures.
- Focus on nonoperative treatment for all types of two-part fractures and fracture dislocations.
Main Results:
- Nonoperative treatment shows comparable effectiveness to conventional plating, antegrade nailing, and Kirschner wiring for two-part surgical neck fractures in older patients.
- Early results of locked plating appear promising but require further investigation.
Conclusions:
- Nonoperative management is a viable and effective option for two-part proximal humeral fractures in the elderly population.
- Evidence for the superiority of locked plating is still developing, necessitating more extensive studies.
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