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Complications of ORIF in Proximal Humeral Fractures

  • Luca La Verde
  • Edoardo Franceschetti
  • Filippo Familiari
  • Francesco Franceschi
Chapter

Abstract

Proximal humeral fractures (PHFs) are complex lesions with difficult management problems, representing a challenge for the orthopaedic surgeon. Many different treatment options have been proposed for these fractures. Open reduction and internal fixation (ORIF) of the proximal humerus represents a good option in selected patients, with encouraging clinical and functional outcomes reported in the literature. Several complications related to ORIF of the proximal humerus have been described over the years. Osteosynthesis of proximal humeral fractures presents different degrees of difficulty according to fracture type and bone quality. Elderly patients, severe osteoporosis, high-energy trauma and severe comminution of the fracture represent the most important predicting factors for risk of complications. Surgeon’s experience represents also a crucial influencing factor for positive outcomes. Complications after ORIF of the proximal humerus can be broadly categorized in three subgroups: (1) alterations of the healing process (malunions, non-unions, avascular necrosis of the humeral head and heterotopic ossifications), (2) hardware failure (screw loosening and pull-out, implant failure, malpositioning and articular perforation) and (3) others (surgical infections, neurovascular lesions, etc.). The aim of this chapter is to present an overview of the complications affecting ORIF in proximal humeral osteosynthesis, with some tips and tricks to avoid them.

Keywords

Proximal humeral fractures ORIF Open reduction and internal fixation Complications Failure Osteosynthesis 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Luca La Verde
    • 1
    • 2
  • Edoardo Franceschetti
    • 2
  • Filippo Familiari
    • 3
  • Francesco Franceschi
    • 2
  1. 1.UOC di Ortopedia e Traumatologia, Policlinico Universitario “G. Martino”MessinaItaly
  2. 2.UOS di Chirurgia dell’Arto Superiore ed Inferiore, Policlinico Universitario “Campus Bio-Medico”RomeItaly
  3. 3.Casa di Cura “Villa del Sole”CatanzaroItaly

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