Which Proximal Humerus Fractures Should Be Pinned? Treatment in Skeletally Immature Patients
| Autor: | Stephanie B. Ihnow, Erik King |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Joint Instability
medicine.medical_specialty Percutaneous Proximal humerus Adolescent Angulated fractures Bone Nails law.invention Intramedullary rod 03 medical and health sciences Fixation (surgical) 0302 clinical medicine Older patients law 030225 pediatrics Humans Medicine Orthopedics and Sports Medicine Range of Motion Articular Child Fractures Malunited 030222 orthopedics Shoulder Joint business.industry Bone age General Medicine Humerus Fracture displacement Fracture Fixation Intramedullary Surgery Treatment Outcome Pediatrics Perinatology and Child Health Shoulder Fractures Bone Remodeling business Bone Wires |
| Zdroj: | Journal of Pediatric Orthopaedics. 36:S44-S48 |
| ISSN: | 0271-6798 |
| DOI: | 10.1097/bpo.0000000000000768 |
| Popis: | Most proximal humerus fractures in skeletally immature individuals are treated nonoperatively with excellent functional results. Extensive remodeling of the proximal humerus and the wide arc of motion of the glenohumeral joint accommodate a large degree of fracture displacement and angulation. The treatment of severely displaced fractures and/or severely angulated fractures continues to be debated. Older patients and those with significantly displaced fractures may benefit from surgery because of their inability to remodel displacement and angulation during their limited remaining growth. The decision to treat a proximal humerus fracture in a skeletally immature patient operatively versus nonoperatively is dependent on the following 3 factors: displacement, bone age, and capacity to remodel. There is an increasing trend toward treating severely displaced and severely angulated fractures surgically, especially in older patients and adolescents. Smooth wires, percutaneous threaded wires, cannulated screws, and retrograde elastic stable intramedullary nailing are acceptable options for fixation. |
| Databáze: | OpenAIRE |
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