Proximal Humerus Fractures ORIF or Hemi - Chris Huber 4/10/2001

Authors

Neer Charles S. ( New York )

Title

Displaced proximal humeral fractures. II.

Treatment of three-part and four-part displacement.

Reference

J Bone Joint Surg Am 1970 Sep;52(6):1090-103

Summary

117 consec cases of 3 and 4-part fractures 31 Rx cons, 43 ORIF, 43 Hemi.

ORIF best for 3-part (63% satis or excellent) and Hemi best for 4-part (82% satisfied)

Critique

Retrospective review. Old paper, but a classic and always quoted in citations. Significance stats lacking. Variety of different ORIF techniques bundled together.

Authors

Resch H, Povacz P, Frohlich R ( Salzburg )

Title

Percutaneous fixation of 3 and 4-part fractures of the proximal humerus

Reference

J Bone Joint Surg Br 1997 Mar;79(2):295-300

Summary

Percut reduction and fixn with 2.7 cann screws in 27 pts. All 3-part fractures gave good-v.good function, Constant score 91%, no AVN. In 4-part fractures Constant score 87%. AVN in 11%. Percutaneous fixation recommended for younger pts with 3 and 4-part fractures in whom hemi less suitable.

Critique

Retrospective. Small numbers

Authors

Tanner M and Cofield R (Mayo Clinic)

Title

Prosthetic arthroplasty for fractures and fracture-dislocations of the proximal humerus

Reference

Clin Orth Oct 1983 (179): 116-128

Summary

Satis pain relief in all 16 acute and 25/28 chronic pts, but better results with early surgery. Abduction av 101 deg (acute), 112 deg (chronic) from 62 deg preop. Tuberosity and cuff repair important

Critique

No confidence intervals or significance testing