Management of proximal and distal humerus fractures:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2000
|
| Series: | The orthopedic clinics of North America
31,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XI, 157 S. zahlr. Ill. |
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| adam_text | MANAGEMENT OF PROXIMAL AND DISTAL HUMERUS FRACTURES
CONTENTS
Preface xi
Frances Cuomo and Shawn O Driscoll
Shoulder
Two Part and Three Part Fractures: Open Reduction and Internal
Fixation Versus Closed Reduction and Percutaneous Pinning 1
Gerald R. Williams, Jr and Kirk L. Wong
Surgical management of two part and three part proximal humerus frac¬
tures is difficult and requires familiarity with more than one method of
fixation. Poor bone quality, comminution, and the deforming forces of the
rotator cuff on the tuberosities influence the choice of operative approach
and fixation techniques. Closed reductions and percutaneous pinning offer
the potential advantage of minimal soft tissue dissection; however, good
bone quality and minimal comminution are prerequisites. Selected two part
surgical neck fractures and valgus impacted fractures lend themselves well
to this technique. Open reduction and internal fixation is indicated in two
part surgical neck fractures with poor bone quality or extensive comminu¬
tion, two part greater tuberosity or lesser tuberosity fractures, and most
three part fractures. The choice of surgical approach is dictated by the frac¬
ture pattern and includes an extended deltopectoral approach and a supe¬
rior deltoid splitting approach. Fixation techniques are myriad and are
dependent on the fracture pattern. Potential fixation methods include intra
medullary rods, interfragmentary sutures or wires, and extramedullary
plates and screws or blade plates. Successful results are predicated on ob¬
taining adequate enough fixation to allow early passive motion. Results also
are influenced by the quality of the reduction and patient compliance.
The Treatment of Chronic Anterior and Posterior Dislocations
of the Glenohumeral Joint and Associated Articular Surface Defects 23
Mark I. Loebenberg and Frances Cuomo
The diagnosis and management of locked dislocations of the glenohumeral
joint remain a challenge for the treating physician. This article addresses
challenges, evaluation and preoperative workup guidelines, and treatment
strategies of chronic anterior and posterior dislocations of the glenohumeral
joint and associated articular surface defects.
THE ORTHOPEDIC CLINICS OF NORTH AMERICA
VOLUME 31 • NUMBER 1 • JANUARY 2000 vii
Proximal Humerus Mahmions 35
Jeffrey A. Siegel and David M. Dines
Malunion of a proximal humerus fracture often is painful and debilitating.
Operative management of this deformity is technically demanding and fre¬
quently results in a relatively high rate of complications. Reconstruction
involves a spectrum of procedures including excision of bony prominences,
tuberosity osteotomy and realignment, and shoulder arthroplasty. This ar¬
ticle covers the etiology, classification, diagnosis, and management of these
complex injuries. A successfully performed reconstruction diminishes the
patient s pain and potentially increases function.
Management of Surgical Neck Nonunions 51
Leesa M. Galatz and Joseph P. Iannotti
A surgical neck nonunion is a seriously debilitating complication of a prox¬
imal humerus fracture. Patients have virtually no functional use of their
shoulders and experience pain. Successful treatment is reliable in relief of
pain and potentially can restore function. The diagnosis is not difficult, how¬
ever, a CT scan may be necessary to identify tuberosity or head splitting
fractures. Successful treatment for these nonunions is difficult but gratifying
because the percent improvement is immense.
Posttraumatic Arthritis 63
J. Michael Wiater and Evan L. Hatow
The surgical management of posttraumatic arthritis is one of the most dif¬
ficult problems encountered in shoulder surgery. Bone and soft tissue ab¬
normalities resulting from the initial injury and from any subsequent sur¬
gery must be addressed to achieve the best outcome possible. A review of
the literature reveals distinctly inferior results and a higher rate of compli¬
cations following surgical treatment of posttraumatic sequelae compared
with the surgical treatment of acute proximal humeral fractures. The authors
present helpful hints for dealing with the complex problems encountered
in the posttraumatic setting.
Complications with Humeral Head Replacement 77
Treg D. Brown and Louis U. Bigliani
Humeral head replacement has been shown to be an excellent surgical op¬
tion for a variety of debilitating shoulder conditions. New techniques and
advances in prosthetic design have furthered the success of this procedure.
When performed without appropriate indications, exacting technique, and
a tailored rehabilitation program, however, complications often result. Early
recognition and appropriate management of these complications aid in
achieving a satisfactory result.
Elboiv
The Triceps Reflecting Anconeus Pedicle (TRAP) Approach
for Distal Humeral Fractures and Nonunions 91
Shawn W. O Driscoll
Adequate exposure is a prerequisite for treatment of distal humeral frac¬
tures, as with most surgical procedures. Challenging as they may be to re¬
duce and fix, these fractures can be made more or less difficult to treat based
viii CONTENTS
on exposure; complications of successful treatment may arise as a result of
the exposure. In this article the authors describe the triceps reflecting an
coneus pedicle (TRAP) approach to the distal humerus, which provides an
extensile and versatile approach for treatment of fractures and nonunions.
The TRAP approach provides almost the same exposure as an olecranon
osteotomy, without the complications of the osteotomy, and has the added
advantage of retaining the whole olecranon to use as a template against
which to assemble the articular fragments of the trochlea.
Fractures of the Distal Humerus 103
David Ring and Jesse B. Jupiter
The quality of elbow function after fracture of the distal humerus is related
to the degree to which normal anatomic relationships are restored. This
article addresses the issues related to fractures of the distal humerus, in¬
cluding challenges, controversies, surgical exposure, postoperative manage¬
ment, and complications.
Fractures of Capitellum and Trochlea 115
Hossein Mehdian and Michael D. McKee
The principles of management of capitellar and trochlear fractures are simi¬
lar to any other intra articular fracture. Accurate anatomic reduction, rigid
internal fixation, and early mobilization of the elbow are prerequisites for a
good functional result. Small fragments with minimal subchondral bone,
not amenable to rigid internal fixation, are best treated by surgical resection.
This article outlines the diagnosis, treatment, controversies, postoperative
results, and complications of these rare elbow fractures.
Posttraumatic Elbow Stiffness 129
Graham J. W. King and Kenneth J. Faber
This article outlines the nonoperative and operative treatment of posttrau¬
matic elbow contractures. Elbow stiffness is a significant cause of disability
because it results in the inability to position the hand in space. Initial treat¬
ment should be nonoperative, consisting of splinting and physical therapy.
Established elbow contractures that interfere with a patient s vocation or
avocations can be treated operatively by either open or arthroscopic release.
The surgical release of posttraumatic elbow contractures is rewarding, with
a high incidence of success and a reasonable risk of complications.
Fractures of the Distal Humerus: Role of Elbow Replacement 145
Bernard F. Morrey
Rigid osteosynthesis and early motion is the well accepted norm to treat
distal humerus fractures. This article addresses the role of elbow replace¬
ment related to fractures of the distal humerus, including indications, tech¬
nique, and results. For severe posttraumatic osteoarthrosis, total elbow re¬
placement using the semiconstrained Coonrad Morrey prosthesis has
proven to be a suitable and reliable option for older patients.
Index 155
Subscription Information Inside back cover
CONTENTS ix
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| spelling | Management of proximal and distal humerus fractures Frances Cuomo ... guest ed. Philadelphia [u.a.] Saunders 2000 XI, 157 S. zahlr. Ill. txt rdacontent n rdamedia nc rdacarrier The orthopedic clinics of North America 31,1 Fracturen gtt Fractures de l'humérus Opperarmbeen gtt Humeral Fractures Humerus Fractures Shoulder Wounds and injuries Therapie (DE-588)4059798-2 gnd rswk-swf Oberarmbruch (DE-588)4172220-6 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Oberarmbruch (DE-588)4172220-6 s Therapie (DE-588)4059798-2 s DE-604 Cuomo, Frances Sonstige (DE-588)1067406913 oth The orthopedic clinics of North America 31,1 (DE-604)BV000001089 31,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008787333&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Management of proximal and distal humerus fractures The orthopedic clinics of North America Fracturen gtt Fractures de l'humérus Opperarmbeen gtt Humeral Fractures Humerus Fractures Shoulder Wounds and injuries Therapie (DE-588)4059798-2 gnd Oberarmbruch (DE-588)4172220-6 gnd |
| subject_GND | (DE-588)4059798-2 (DE-588)4172220-6 (DE-588)4143413-4 |
| title | Management of proximal and distal humerus fractures |
| title_auth | Management of proximal and distal humerus fractures |
| title_exact_search | Management of proximal and distal humerus fractures |
| title_full | Management of proximal and distal humerus fractures Frances Cuomo ... guest ed. |
| title_fullStr | Management of proximal and distal humerus fractures Frances Cuomo ... guest ed. |
| title_full_unstemmed | Management of proximal and distal humerus fractures Frances Cuomo ... guest ed. |
| title_short | Management of proximal and distal humerus fractures |
| title_sort | management of proximal and distal humerus fractures |
| topic | Fracturen gtt Fractures de l'humérus Opperarmbeen gtt Humeral Fractures Humerus Fractures Shoulder Wounds and injuries Therapie (DE-588)4059798-2 gnd Oberarmbruch (DE-588)4172220-6 gnd |
| topic_facet | Fracturen Fractures de l'humérus Opperarmbeen Humeral Fractures Humerus Fractures Shoulder Wounds and injuries Therapie Oberarmbruch Aufsatzsammlung |
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