Background: The treatment of proximal humerus fractures (PHF) is largely surgeon dependent with no clear guidelines for selecting the optimal method of treatment.
Aims: The aim of this study was to evaluate trends and variations in treatment methods of PHF in the United States from 2004 to 2012 and to determine the regional differences in treatment.
Methods: The National Inpatient Sample was used to identify all patient discharges with diagnosis codes for PHF and the data were classified based on ICD-9 procedure codes. Patient and hospital demographics were also analyzed. Simple linear regression analyses were performed for each treatment modality to evaluate current treatment trends and to extrapolate the future trends of PHF treatment over the next 20 years.
Results: A national estimate of 550,116 PHF discharges was identified over the time period. Significant correlations between change over time and treatment modality were found for reverse shoulder arthroplasty (RSA) (r = 0.903, p < 0.001), open reduction internal fixation (r = 0.876, p = 0.002), and closed reduction internal fixation (r = -0.922, p < 0.001). The RSA regression model showed that by the year 2032, PHF treated with RSA will increase 100% from 2012.
Discussion: There were significant changes in treatment modalities for PHF from 2004 to 2012; The projected number of RSA used to treat PHF will be about 9115 in 2032, compared to 340 in 2004.
Conclusion: Overall, there was a growth in proximal humerus fractures treated in an inpatient setting in the United States. RSA had the greatest proportional increase over time, but only accounted for less than 2% of total interventions.
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http://dx.doi.org/10.1007/s40520-016-0695-2 | DOI Listing |
Vet Radiol Ultrasound
January 2025
Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK.
Two skeletally immature female dogs were each investigated for chronic weight-bearing thoracic limb lameness. The first patient was lame for 2 months following a tumble whilst playing, and the second patient had been intermittently lame since 3 weeks of age. In both cases, radiographic examination of the shoulder revealed fissuring of the caudal humeral head consistent with an incomplete proximal humeral Salter-Harris type IV fracture with an Enoki-mushroom-like appearance of the caudal fragment, where two heads rise from a common stem.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
Background: Finite element analysis (FEA) could advance the understanding of fracture fixation and guide the choice of surgical treatment. This study aimed to compare two internal fixation methods in the treatment of displaced proximal humeral fracture (PHF) through FEA.
Methods: Three-dimensional FEA model based on the left shoulder joint of a 67-year-old female patient with PHFs and osteoporosis was adopted, in order to analyze the fixation effect and load stress distribution of internal fixation plates with open reduction and intramedullary nails without opening the fracture in the treatment of Neer III-VI PHF.
PLoS One
January 2025
Division of Arthroscopic and special Joint Surgery / Sports Injuries, Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany.
Background: The number of reverse shoulder arthroplasty (RSA) procedures performed worldwide has increased over the last 10 years, with a corresponding increase in revision shoulder arthroplasty (SRSA). SRSA is often used for post-traumatic revision surgery in cases of infections and failure of anatomical prostheses. Data on outcomes with specific detail for each indication for the prosthetic solution as a secondary treatment are scarce, and inhomogeneous.
View Article and Find Full Text PDFCureus
December 2024
Orthopedics and Traumatology, Istanbul University-Cerrahpasa, Istanbul, TUR.
PLoS One
December 2024
Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom.
Background: Shoulder fractures (proximal humerus fractures) are common, painful, debilitating injuries. Recovery is a long process often hindered by complications such as mal-union and frozen shoulder. The purpose of this qualitative study was to explore the experiences and information needs of people at different time points after a shoulder fracture and how views on recovery change over time.
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