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Fractures of the Shoulder and Elbow

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Fractures in the Elderly

Part of the book series: Aging Medicine ((AGME))

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Abstract

Fractures of the shoulder and elbow are common in the elderly population. Osteopenia and osteoporosis put this population at risk for fractures from low-energy trauma. The majority of fractures of the shoulder and elbow in this population are best managed nonoperatively. However, surgical intervention with open or closed reduction with fixation, shoulder arthroplasty, or total elbow arthroplasty may offer more predictable and better functional outcomes for certain fracture patterns. Regardless of the treatment modality, the goal of treating these injuries is to provide stable fracture fixation or reconstruction to allow early mobilization and pain-free upper extremity function.

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References

  1. Bioleau P, Huten D, Pietu G, et al. L’arthroplastie prosthetique dans les fractures recentes complexes de l’extremite superieure de l’humerus: technique et inidications. Paris: Paris Expansion Scientifique Publications; 1999.

    Google Scholar 

  2. Kronberg M, Brwostom LA, Soderlund V. Retroversion of the humeral head in the normal shoulder and its relationship to the normal range of motion. Clin Orthop Relat Res. 1990;153:113–7.

    Google Scholar 

  3. Iannotti JP, Gabreil JP, Schneck SL, et al. The normal glenohumeral relationships. An anatomical study of one hundred and forty shoulders. J Bone Joint Surg. 1992;74A:491–500.

    Article  Google Scholar 

  4. Horak J, Nilsson BE. Epidemiology of fracture of the upper end of the humerus. Clin Orthop Relat Res. 1975;112:250–3.

    Article  Google Scholar 

  5. Baron JA, Barrett JA, Karagas MR. The epidemiology of peripheral fractures. Bone. 1996;18(3 Suppl):209S–13S.

    Article  CAS  PubMed  Google Scholar 

  6. Court-Brown CM, Garg A, McQueen MM. The translated two-part fracture of the proximal humerus. J Bone Joint Surg Br. 2001;83-B:799–804.

    Article  Google Scholar 

  7. Bell JE, Leung BC, Spratt KF, et al. Trends and variation in incidence, surgical treatment, and repeat surgery of proximal humerus fractures in the elderly. JBJS Am. 2011;93(2):121–31.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humerus fractures. Acta Orthop Scand. 2001;72(4):365–71.

    Article  CAS  PubMed  Google Scholar 

  9. Abrahamsen B, Vestergaard P, Rud B, et al. Ten-year absolute risk of osteoporotic fractures according to BMD T score at menopause: the Danish osteoporosis prevention study. J Bone Miner Res. 2006;21:796–800.

    Article  PubMed  Google Scholar 

  10. Lee SH, Dargent-Molina P, Breart G. Risk factors for fractures of the proximal humerus: results from the EPIDOS prospective study. J Bone Miner Res. 2002;17:817–25.

    Article  PubMed  Google Scholar 

  11. Lauritzen J, Schwarz P, McNair P, et al. Radial and humeral fractures as predictors of subsequent fractures in women, and their seasonal variations. Osteoporos Int. 1993;2:133–7.

    Article  Google Scholar 

  12. Neer CS. Displaced proximal humerus fractures: I. Classification and evaluation. J Bone Joint Surg Am. 1970;52:1077–89.

    Article  PubMed  Google Scholar 

  13. Pritchett JW. Inferior subluxation of the humeral head after trauma or surgery. J Shoulder Elb Surg. 1997;6(4):356–9.

    Article  CAS  Google Scholar 

  14. Brooks CH, Revell WJ, Heatley FW. Vascularity of the humeral head after proximal humeral fractures: an anatomical cadaver study. J Bone Joint Surg Br. 1993;75:132–6.

    Article  CAS  PubMed  Google Scholar 

  15. Gerber C, Werner CM, Vienne P. Internal fixation of complex fractures of the proximal humerus. J Bone J Surg Br. 2004;86:848–55.

    Article  CAS  Google Scholar 

  16. Schlegel TF, Hawkins RJ. Displaced proximal humerus fractures: evaluation and treatment. J Am Acad Orthop Surg. 1994;2:54–78.

    Article  CAS  PubMed  Google Scholar 

  17. Handoll HH, Ollivere BJ, Rollins KE. Interventions for treating proximal humeral fractures in adults. Cochrane Database Syst Rev. 2012;(12):CD000434.

    Google Scholar 

  18. Handoll HH, Keding A, Corbacho B, et al. Five-year follow-up results of the PROFHER trial comparing operative and non-operative treatment of adults with a displaced fracture of the proximal humerus. Bone Joint J. 2017;99-B:383–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Rangan A, Handoll H, Brealey S, et al. Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial. JAMA. 2015;313(10):1037–47.

    Article  CAS  PubMed  Google Scholar 

  20. Tingart MS, Apprelexa M, von Stechow D, et al. The cortical thickness of the proximal humeral diaphysis predicts bone mineral density of the proximal humerus. J Bone Joint Surg Br. 2003;85:611–7.

    Article  PubMed  Google Scholar 

  21. Resch H, Povacz P, Frohlich R, et al. Percutaneous fixation of three- and four-part fractures of the proximal humerus. J Bone Joint Surg Br. 1997;79:295–300.

    Article  CAS  PubMed  Google Scholar 

  22. Egol KA, Kubiak EN, Fulkerson E, et al. Biomechanics of locked plates and screws. J Orthop Trauma. 2004;18:488–93.

    Article  PubMed  Google Scholar 

  23. Cornell CN. Internal fracture fixation in patients with osteoporosis. J Am Acad Orthop Surg. 2003;11:109–19.

    Article  PubMed  Google Scholar 

  24. Flatow EL, Cuomo F, Madey MG, et al. Open reduction and internal fixation of two-part displaced fractures of the greater tuberosity of the proximal part of the humerus. J Bone Joint Surg Am. 1991;73:1213–8.

    Article  CAS  PubMed  Google Scholar 

  25. Wijgman AJ, Roolker W, Patt TW, et al. Open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus. J Bone Joint Surg Am. 2002;84:1919–25.

    Article  PubMed  Google Scholar 

  26. Wagner M. General principles for the clinical use of the LCP. Injury. 2003;34(Suppl 2):B31–42.

    Article  PubMed  Google Scholar 

  27. Haidukewych GJ. Innovations in locking plate technology. J Am Acad Orthop Surg. 2004;2:205–12.

    Article  Google Scholar 

  28. Chudik SC, Weinhold P, Dahners LE. Fixed-angle plate fixation in simulated fractures of the proximal humerus: a biomechanical study of a new device. J Shoulder Elb Surg. 2003;12:578–88.

    Article  Google Scholar 

  29. Zyto K, Wallace WA, Frostick SP, et al. Outcome after hemiarthroplasty for three- and four-part fractures of the proximal humerus. J Shoulder Elb Surg. 1998;7:85–9.

    Article  CAS  Google Scholar 

  30. Jakob RP, Miniaci A, Anson PS, et al. Four-part valgus impacted fractures of the proximal humerus. J Bone Joint Surg Br. 1991;73:295–8.

    Article  CAS  PubMed  Google Scholar 

  31. Mighell MA, Kolm GP, Collinge CA, et al. Outcomes of hemiarthroplasty for fractures of the proximal humerus. J Shoulder Elb Surg. 2003;12:569–77.

    Article  Google Scholar 

  32. Kralinger F, Schwaiger R, Wambacher M, et al. Outcome after primary hemiarthroplasty for fracture of the head of the humerus: a retrospective multicenter study of 167 patients. J Bone Joint Surg Br. 2004;86:217–9.

    Article  CAS  PubMed  Google Scholar 

  33. Christoforakis JJ, Kontakis GM, Katonis PG, et al. Shoulder hemiarthroplasty in the management of humeral head fractures. Acta Orthop Belg. 2004;70:214–8.

    PubMed  Google Scholar 

  34. Demirhan M, Kilicoglu O, Altinel L, et al. Prognostic factors in prosthetic replacement for acute proximal humerus fractures. J Orthop Trauma. 2003;17:181–8.

    Article  PubMed  Google Scholar 

  35. Nyffeler RW, Sheikh R, Jacob HA, et al. Influence of humeral prosthesis height on biomechanics of glenohumeral abduction: an in vitro study. J Bone Joint Surg Am. 2004;86:575–80.

    Article  PubMed  Google Scholar 

  36. Bono CM, Renard R, Levin RD, et al. Effect of displacement of fractures of the greater tuberosity on the mechanics of the shoulder. J Bone J Surg Br. 2001;83:1056–62.

    Article  CAS  Google Scholar 

  37. Frankle MA, Greenwald DP, Marke BA, et al. Biomechanical effects of malposition of tuberosity fragments on the humeral prosthetic reconstruction for four-part proximal humerus fractures. J Shoulder Elb Surg. 2001;10:321–6.

    Article  CAS  Google Scholar 

  38. Prakash U, McGurty DW, Dent JA. Hemiarthroplasty for severe fractures of the proximal humerus. J Shoulder Elb Surg. 2002;11:428–30.

    Article  Google Scholar 

  39. Bufquin T, Hersan A, Hubert L, et al. Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly. J Bone Joint Surgery Br. 2007;89B:516–20.

    Article  Google Scholar 

  40. Hodgson S. Proximal humerus fracture rehabilitation. Clin Orthop Relat Res. 2006;442:131–8.

    PubMed  Google Scholar 

  41. Zyto K, Ahrengart L, Sperber A, et al. Treatment of displaced proximal humeral fractures in elderly patients. J Bone Joint Surg Br. 1997;79:412–7.

    Article  CAS  PubMed  Google Scholar 

  42. Fu T, Xia C, Li Z, et al. Surgical versus conservative treatment for displaced proximal humeral fractures in elderly patients: a meta-analysis. Int J Clin Exp Med. 2014;7(12):4607–15.

    PubMed  PubMed Central  Google Scholar 

  43. Hanson B, Neidenbach P, de Boer P, et al. Functional outcomes after nonoperative management of fractures of the proximal humerus. J Shoulder Elb Surg. 2009;18(4):612–21.

    Article  Google Scholar 

  44. Foruria AM, de Gracia MM, Larson DR, et al. The pattern of the fracture and displacement of the fragments predict the outcome in proximal humeral fractures. J Bone Joint Surg Br. 2011;93(3):378–86.

    Article  CAS  PubMed  Google Scholar 

  45. Yin B, Moen TC, Thompson SA, et al. Operative treatment of isolated greater tuberosity fractures: retrospective review of clinical and functional outcomes. Orthopedics. 2012;35(6):e807–14.

    Article  PubMed  Google Scholar 

  46. Olerud P, Ahrengart L, Ponzer S, et al. Internal fixation versus nonoperative treatment of displaced 3-part proximal humerus fractures in elderly patients: a randomized controlled trial. J Shoulder Elb Surg. 2011;20:747–55.

    Article  Google Scholar 

  47. Petrigliano FA, Bezrukov N, Gamradt SC, et al. Factors predicting complication and reoperation rates following surgical fixation of proximal humerus fractures. JBJS Am. 2014;96(18):1544–51.

    Article  PubMed  Google Scholar 

  48. Olerud P, Ahrengart L, Ponzer S, et al. Hemiarthroplasty versus nonoperative treatment of displaced 4-part proximal humerus fractures in elderly patients: a randomized controlled trial. J Shoulder Elb Surg. 2011;20(7):1025–33.

    Article  Google Scholar 

  49. Namdari S, Horneff JG, Baldwin K. Comparison of hemiarthroplasty and reverse arthroplasty for treatment of proximal humeral fractures: a systematic review. J Bone Joint Surg Am. 2013;95(18):1701–8.

    Article  PubMed  Google Scholar 

  50. Cuff DJ, Pupello DR. Comparison of hemiarthroplasty and reverse shoulder arthroplasty for the treatment of proximal humeral fractures in elderly patients. J Bone Joint Surg Am. 2013;95(22):2050–5.

    Article  PubMed  Google Scholar 

  51. Thorsness R, English C, Gross J, et al. Proximal humerus fractures with associated axillary artery injury. J Ortho Trauma. 2014;28(11):659–63.

    Article  Google Scholar 

  52. Visser CP, Coene LN, Brand R, et al. Nerve lesions in proximal humerus fractures. J Should Elbow Surg. 2001;10:421–7.

    Article  CAS  Google Scholar 

  53. Gallo RA, Sciulli R, Daffner RH, et al. Defining the relationship between rotator cuff injury and proximal humerus fractures. CORR. 2007;458:70–7.

    Google Scholar 

  54. Brinker MR, O’Connor DP. The incidence of fractures and dislocations referred for orthopaedic services in a capitated population. J Bone Joint Surg Am. 2004;86:290–7.

    Article  PubMed  Google Scholar 

  55. Chen F, Wang Z, Bhattacharyya T. Outcomes of nails versus plates for humeral shaft fractures: a Medicare cohort study. J Orthop Trauma. 2013;27(2):68–72.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Tytherleigh-Strong G, Walls N, McQueen MM. The epidemiology of humeral shaft fractures. J Bone Joint Surg Br. 1998;80B:249–53.

    Google Scholar 

  57. Ekholm R, Adami J, Tidermark J, et al. Fractures of the shaft of the humerus: an epidemiological study of 401 fractures. J Bone Joint Surg Br. 2006;88B:1469–73.

    Article  Google Scholar 

  58. Huttunen TT, Kannus P, Lepola V, et al. Surgical treatment of humeral-shaft fractures: a register-based study in Finland between 1987 and 2009. Injury. 2012;43(10):1704–8.

    Article  PubMed  Google Scholar 

  59. Denard A Jr, Richards JE, Obremskey WT, et al. Outcome of nonoperative vs operative treatment of humeral shaft fractures: a retrospective study of 213 patients. Orthopedics. 2010;33(8)

    Google Scholar 

  60. Sarmiento A, Kinman PB, Galvin EG, et al. Functional bracing of fractures of the shaft of the humerus. J Bone Joint Surg Am. 1977;59:596–601.

    Article  CAS  PubMed  Google Scholar 

  61. Foster FJ, Dixon JL, Bach AW, et al. Internal fixations of fractures and nonunions of the humeral shaft. J Bone Joint Surg Am. 1985;67:857–64.

    Article  CAS  PubMed  Google Scholar 

  62. Mast JW, Spiegal PG, Harvey JP, et al. Fractures of the humeral shaft. Clin Orthop Relat Res. 1975;12:254–62.

    Google Scholar 

  63. McKee MD, Seiler J, Jupiter JB. The application of the limited contact dynamic compression plate in the upper extremity; an analysis of 114 cases. Injury. 1995;26:661–6.

    Article  CAS  PubMed  Google Scholar 

  64. Connolly S, Nair R, McKee MD, et al. Immediate plate osteosynthesis of open fractures of the humeral shaft. final program of the orthopaedic trauma association annual meeting, October 22–24, 1999, Charlotte, NC. Rosemont: Orthopaedic Trauma Association; 1999.

    Google Scholar 

  65. Hak DJ. Comparison of the AO locking plate with the standard limited-contact dynamic compression plate for fixation of osteoporotic humeral shaft fractures, final program of the orthopaedic trauma association annual meeting, October 9–11, 2003, Salt Lake City, UT. Rosemont: Orthopaedic Trauma Association; 2003.

    Google Scholar 

  66. Sarmiento A, Zagorski JB, Zych GA, et al. Functional bracing for the treatment of fractures of the humeral diaphysis. J Bone Joint Surg Am. 2000;82A:478–86.

    Article  Google Scholar 

  67. Shields E, Sundem L, Childs S, et al. Factors predicting patient-reported functional outcome scores after humeral shaft fractures. Injury. 2015;46(4):693–8.

    Article  PubMed  Google Scholar 

  68. Foulk DA, Szabo RM. Diaphyseal humerus fractures: natural history and occurrence of nonunion. Orthopedics. 1995;18(4):333–5.

    CAS  PubMed  Google Scholar 

  69. Chapman JR, Henley MB, Agel J, et al. Randomized prospective study of humeral shaft fracture fixation: intramedullary nails versus plates. J Orthop Trauma. 2000;14:162–6.

    Article  CAS  PubMed  Google Scholar 

  70. McCormack RG, Brien D, Buckley RE, et al. Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail: a prospective randomized trial. J Bone Joint Surg Br. 2000;82:336–9.

    Article  CAS  PubMed  Google Scholar 

  71. Rarragos AF, Schemitxch ED, McKee MD. Complications of intramedullary nailing for fractures of the humeral shaft: a review. J Orthop Trauma. 1999;13:258–67.

    Article  Google Scholar 

  72. Mahabier KC, Vogels LM, Punt BJ, et al. Humeral shaft fractures: retrospective results of non-operative and operative treatment of 186 patients. Injury. 2013;44(4):427–30.

    Article  PubMed  Google Scholar 

  73. Bhandari M, Devereaux PJ, McKee MD, et al. Compression plating versus intramedullary nailing of humeral shaft fractures-a meta-analysis. Acta Orthop. 2006;77(2):279–84.

    Article  PubMed  Google Scholar 

  74. Ekholm R, Adami J, Tidermark J, et al. Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J Bone Joint Surg Br. 2006;88(11):1469–73.

    Article  CAS  PubMed  Google Scholar 

  75. Li Y, Ning G, Wu Q, et al. Review of literature of radial nerve injuries associated with humeral fractures-an integrated management strategy. PLoS One. 2013;8(11):e78576.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Gainor BJ, Metzler M. Humeral shaft fracture with brachial artery injury. Clin Orthop Relat Res. 1986;(204):154–61.

    Google Scholar 

  77. Barei DP, Hanel DP. Fractures of the distal humerus. In: Green DP, Hotchkiss RN, Pederson WC, et al., editors. Greens’ operative hand surgery, vol. 1. 5th ed. Philadelphia: Elsevier, Inc; 2005. p. 809–43.

    Google Scholar 

  78. Jupiter JB, Mehne DK. Fractures of the distal humerus. Orthopedics. 1992;15(7):825–33.

    CAS  PubMed  Google Scholar 

  79. Ellwein A, Lill H, Voigt C, et al. Arthroplasty compared to internal fixation by locking plate osteosynthesis in comminuted fractures of distal humerus. Int Orthop. 2015;39:747–54.

    Article  PubMed  Google Scholar 

  80. Palvanen M, Niemi S, Parkkari J, et al. Osteoporotic fractures of the distal humerus in elderly women. Ann Intern Med. 2003;139(3):235.

    Article  Google Scholar 

  81. Charissoux JL, Vergnenegre G, Pelissier M, et al. Epidemiology of distal humerus fractures in the elderly. OrthopTraumatol Surg Res. 2013;99(7):627–31.

    Google Scholar 

  82. Palvanen M, Kannus P, Niemi S, et al. Secular trends in distal humeral fractures of elderly women: nationwide statistics in Finland between 1970 and 2007. Bone. 2010;46(5):1355–8.

    Article  PubMed  Google Scholar 

  83. Zayer M, Mathiesen TI. Relevancy of radiographic features in elbow fractures. Acta Radiol. 1997;38(3):363–7.

    Article  CAS  PubMed  Google Scholar 

  84. Jupiter JB, Barnes KA, Goodman LJ, et al. Multiplane fracture of the distal humerus. J Orthop Trauma. 1993;7(3):216–20.

    Article  CAS  PubMed  Google Scholar 

  85. Mehne DK, Matta J. Bicolumn fractures of the adult humerus. In: 53rd Annual Meeting of the American Academy of Orthopaedic Surgeons, New Orleans, 1986.

    Google Scholar 

  86. Pidhorz L, Alligand-Perrin P, De Keating E, et al. Distal humerus fracture in the elderly: does conservative treatment still have a role? Orthop Traumatol Surg Res. 2013;99(8):739–44.

    Article  Google Scholar 

  87. Egol KA, Tsai P, Vazques O, et al. Comparison of functional outcomes of total elbow arthroplasty vs plate fixation for distal humerus fractures in osteoporotic elbows. Am J Orthop. 2011;40(2):67–71.

    PubMed  Google Scholar 

  88. Chalidis B, Dimitriou C, Papadopoulos P, et al. Total elbow arthroplasty for the treatment of insufficient distal humeral fractures. A retrospective clinical study and review of literature. Injury. 2009;40(6):582–90.

    Article  CAS  PubMed  Google Scholar 

  89. Anglen J. Distal humerus fractures. J Am Acad Orthop Surg. 2005;12:291–7.

    Article  Google Scholar 

  90. Morrey BR, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981;63(6):872–7.

    Article  CAS  PubMed  Google Scholar 

  91. Helfet DL, Schmeling GJ. Bicondylar intraarticular fractures of the distal humerus in adults. Clin Orthop Relat Res. 1993;(292):23–36.

    Google Scholar 

  92. Jupiter JB. Complex fractures of the distal part of the humerus and associated complications. Instr Course Lect. 1995;44:187–98.

    CAS  PubMed  Google Scholar 

  93. Gofton WT, Macdermoid JC, Patterson SD, et al. Functional outcome of AO type C distal humeral fractures. J Hand Surg Am. 2003;28(2):294–308.

    Article  PubMed  Google Scholar 

  94. Worden A, Ilyas AM. Ulnar neuropathy following distal humerus fracture fixation. Orthop Clin North Am. 2012;43(4):509–14.

    Article  PubMed  Google Scholar 

  95. Douglas K, Cannada LK, Archer KR, et al. Incidence and risk factors of heterotopic ossification following major elbow trauma. Orthopedics. 2012;35(6):e815–22.

    Article  PubMed  Google Scholar 

  96. John H, Rosso R, Neff U, et al. Operative treatment of distal humeral fractures in the elderly. J Bone J Surg Br. 1994;76(5):793–6.

    Article  CAS  Google Scholar 

  97. Pereles TR, Koval KJ, Gallagher M, et al. Open reduction and internal fixation of the distal humerus: functional outcome in the elderly. J Trauma. 1997;43(4):578–84.

    Article  CAS  PubMed  Google Scholar 

  98. Mckee MD, Veillette CJ, Hall JA, et al. A multicenter, prospective, randomized, controlled trial of open reduction-internal fixation versus total elbow arthroplasty for displaced intraarticular distal humeral fractures in elderly patients. J Shoulder Elb Surg. 2009;18:3–12.

    Article  Google Scholar 

  99. Frankle MA, Herscovici D Jr, DiPasquale TG, et al. A comparison of open reduction and internal fixation and primary total elbow arthroplasty in the treatment of intraarticular distal humerus fractures in women older than age 65. J Orthop Trauma. 2003;17(7):473–80.

    Article  PubMed  Google Scholar 

  100. King GJ. Fractures of the head of the radius. In: Green DP, Hotchkiss RN, Pederson WC, et al., editors. Greens’ operative hand surgery, vol. 1. 5th ed. Philadelphia: Elsevier, Inc; 2005. p. 845–87.

    Google Scholar 

  101. Mezera K, Hotchkiss RN. Fractures and dislocations of the elbow. In: Bucholz RW, Heckman JD, editors. Rockwood and Green’s fractures in adults, vol. 1. 5th ed. Philadelphia: Lippincott, Williams, & Wilkins; 2002. p. 921–52.

    Google Scholar 

  102. Tejwani NC, Mehta H. Fractures of the radial head and neck: current concepts in management. JAAOS. 2007;15(7):380–7.

    PubMed  Google Scholar 

  103. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow: a definition of primary and secondary constraints. Clin Orthop Relat Res. 1991;(265):187–95.

    Google Scholar 

  104. Kumar V, Wallace WA. Radial head fractures – update on classification and management. Orthop Trauma. 2012;26(2):124–31.

    Article  Google Scholar 

  105. Morrey BF, An KN, Stormont TJ. Force transmission through the radial head. J Bone Joint Surg Am. 1988;70(2):250–6.

    Article  CAS  PubMed  Google Scholar 

  106. Duckworth AD, Clement ND, Jenkins PJ, et al. The epidemiology of radial head and neck fractures. J Hand Surg. 2012;37:112–9.

    Article  Google Scholar 

  107. Kaas L, van Riet RP, Vroemen JP, et al. The epidemiology of radial head fractures. J Shoulder and Elbow Surgery. 2010;19(4):520–3.

    Article  Google Scholar 

  108. Greenspan A, Norman A, Rosen H. Radial head-capitellum view in elbow trauma: clinical application and radiographic-anatomic correlation. Am J Roentgenol. 1984;143(2):355–9.

    Article  CAS  Google Scholar 

  109. O’Dwyer H, O’Sullivan P, Fitzgerald D, et al. The fat pad sign following elbow trauma in adults: its usefulness and reliability in suspecting occult fracture. J Comput Assist Tomogr. 2004;28(4):562–5.

    Article  PubMed  Google Scholar 

  110. Hotchkiss RN. Displaced fractures of the radial head: internal fixation or excision? JAAOS. 1997;5:1–10.

    CAS  PubMed  Google Scholar 

  111. Struijs PA, Smit G, Steller EP. Radial head fractures: effectiveness of conservative treatment versus surgical intervention. A systematic review. Arch Orthop Trauma Surg. 2007;127:125–30.

    Article  CAS  PubMed  Google Scholar 

  112. Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am. 2002;84-A(10):1811–5.

    Article  PubMed  Google Scholar 

  113. King GJ, Evans DC, Kellam JF. Open reduction and internal fixation of radial head fractures. J Orthop Trauma. 1991;5(1):21–8.

    Article  CAS  PubMed  Google Scholar 

  114. Adler JB, Shaftan GW. Radial head fractures, is excision necessary? J Trauma. 1962;4:115–36.

    Article  Google Scholar 

  115. Morrey BF, Askew L, Chao EY. Silastic prosthetic replacement for the radial head. J Bone Joint Surg Am. 1981;63(3):454–8.

    Article  CAS  PubMed  Google Scholar 

  116. Harding P, Rasekaba T, Smirneos L, et al. Early mobilisation for elbow fractures in adults. Cochrane Database Syst Rev. 2011;15(6):CD008130.

    Google Scholar 

  117. Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42(172):123–32.

    Article  CAS  PubMed  Google Scholar 

  118. Zwingmann J, Welzel M, Dovi-Akue D, et al. Clinical results after different operative treatment methods of radial head and neck fractures: a systematic review and meta-analysis of clinical outcome. Injury. 2013;44:1540–50.

    Article  CAS  PubMed  Google Scholar 

  119. Al-Burdeni S, Abuodeh Y, Ibrahim T, et al. Open reduction and internal fixation versus radial head arthroplasty in the treatment of adult closed comminuted radial head fractures (modified Mason III and IV). Int Orthop. 2015;39(8):1659–64.

    Article  PubMed  Google Scholar 

  120. Harrington IJ, Sekyi-Out A, Barrington TW, et al. The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma. 2001;50:46–52.

    Article  CAS  PubMed  Google Scholar 

  121. Knight DJ, Rymaszewski LA, Amis AA, et al. Primary replacement of the fracture radial head with a metal prosthesis. J Bone J Surg Br. 1993;75(4):572–6.

    Article  CAS  Google Scholar 

  122. Li N, Chen S. Open reduction and internal-fixation versus radial head replacement in treatment of Mason type III radial head fractures. Eur J Orthop Surg Traumatol. 2014;24(6):851–5.

    Article  PubMed  Google Scholar 

  123. Chen X, Wang SC, Cao LH, et al. Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop. 2011;35(7):1071–6.

    Article  PubMed  Google Scholar 

  124. Herbertsson P, Josefsson PO, Hasserius R, et al. Fractures of the radial head and neck treated with radial head excision. J Bone Joint Surg Am. 2004;86:1925–30.

    Article  PubMed  Google Scholar 

  125. Ikeda M, Oka Y. Function after early radial head resection for fracture: a retrospective evaluation of 15 patients followed for 3-18 years. Acta Orthop Scand. 2000;71(2):191–4.

    Article  CAS  PubMed  Google Scholar 

  126. Diliberti T, Botte MJ, Abrams RA. Anatomical considerations regarding the posterior interosseous nerve during posterolateral approaches to the proximal part of the radius. J Bone Joint Surg Am. 2000;82(6):809–13.

    Article  CAS  PubMed  Google Scholar 

  127. King GJ, Faber KJ. Posttraumatic elbow stiffness. Orthop Clin North Am. 2000;31(1):129–43.

    Article  CAS  PubMed  Google Scholar 

  128. Morrey BF. Anatomy of the elbow joint. In: Morrey BF, editor. The elbow and its disorders. 2nd ed. Philadelphia: WB Saunders; 1993. p. 16–52.

    Google Scholar 

  129. Ring D, Jupiter JB. Fractures of the proximal ulna. In: Green DP, Hotchkiss RN, Pederson WC, et al., editors. Green’s operative hand surgery, vol. 1. 5th ed. Philadelphia: Elsevier, Inc; 2005. p. 889–906.

    Google Scholar 

  130. Morrey BF. Current concepts in the treatment of fractures of the radial head, the olecranon, and the coronoid. J Bone Joint Surg Am. 1995;77(2):316–27.

    Article  Google Scholar 

  131. Snoody MC, Lang MF, An TJ, et al. Olecranon fractures: factors influencing re-operation. Int Orthop. 2014;38(8):1711–6.

    Article  Google Scholar 

  132. Duckworth AD, Clement ND, Aitken SA, et al. The epidemiology of fractures of the proximal ulna. Injury. 2012;43(3):343–6.

    Article  PubMed  Google Scholar 

  133. Lauritzen JB, Lund B. Risk of hip fracture after osteoporosis fractures: 451 women with fracture of lumbar spine, olecranon, knee or ankle. Acta Orthop Scand. 1993;64(3):297–300.

    Article  CAS  PubMed  Google Scholar 

  134. Cabanela ME, Morrey BF. Fractures of the proximal ulna and olecranon. In: Morrey BF, editor. The elbow and its disorders. 2nd ed. Philadelphia, PA: WB Saunders; 1993. p. 405–28.

    Google Scholar 

  135. Duckworth AD, Bugler KE, Clement ND, et al. Nonoperative management of displaced olecranon fractures in low-demand elderly patients. J Bone Joint Surg Am. 2014;96(1):67–72.

    Article  PubMed  Google Scholar 

  136. Symes M, Harris IA, Limbers J, Joshi M. SOFIE: surgery for olecranon fractures in the elderly: a randomised controlled trial of operative versus non-operative treatment. BMC Musculoskelet Disord. 2015;16:324.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  137. Karlsson MK, Hasserius R, Karlsson C, et al. Fractures of the olecranon: a 15- to 25-year followup of 73 patients. Clin Orthop Relat Res. 2002;403:205–12.

    Article  Google Scholar 

  138. Matar HE, Ali AA, Buckley S, et al. Surgical interventions for treating fractures of the olecranon in adults. Cochrane Database Syst Rev. 2014;26(11):CD10144.

    Google Scholar 

  139. Newman SD, Mauffrey C, Krikler S. Olecranon fractures. Injury. 2009;40(6):575–81.

    Article  CAS  PubMed  Google Scholar 

  140. Wolfgang G, Burke F, Bush D, et al. Surgical treatment of displaced olecranon fractures by tension band wiring technique. Clin Orthop Relat Res. 1987;(224):192–204.

    Google Scholar 

  141. Hak DJ, Golladay GJ. Olecranon fractures: treatment options. J Am Acad Orthop Surg. 2000;8(4):226–75.

    Article  Google Scholar 

  142. Gallucci GL, Piuzzi NS, Slullitel PA, et al. Non-surgical functional treatment for displaced olecranon fractures in the elderly. Bone Joint J. 2014;96-B(4):530–4.

    Article  CAS  PubMed  Google Scholar 

  143. Veras Del Monte L, Sirera Vercher M, Busquets Net R, et al. Conservative treatment of displaced fractures of the olecranon in the elderly. Injury. 1999;30(2):105–10.

    Article  CAS  PubMed  Google Scholar 

  144. Gartsman GM, Sculco TP, Otis TC. Operative treatment of olecranon fractures. Excision or open reduction with internal fixation. J Bone Joint Surg Am. 1981;63(5):718–21.

    Article  CAS  PubMed  Google Scholar 

  145. Tarallo L, Mugnai R, Adani R, et al. Simple and comminuted displaced olecranon fractures: a clinical comparison between tension band wiring and plate fixation techniques. Arch Orthop Trauma Surg. 2014;134(8):1107–14.

    Article  PubMed  Google Scholar 

  146. Catalano LW 3rd, Crivello K, Lafer MP, et al. Potential dangers of tension band wiring of olecranon fractures: an anatomic study. J Hand Surg. 2011;36(10):1659–62.

    Article  Google Scholar 

  147. Helm RH, Hornby R, Miller SW. The complications of surgical treatment of displaced fractures of the olecranon. Injury. 1987;18:48–50.

    Article  CAS  PubMed  Google Scholar 

  148. Yi PH, Weening AA, Shin SR, et al. Injury patterns and outcomes of open fractures of the proximal ulna do not differ from closed fractures. Clin Orthop Relat Res. 2014;472(7):2100–4.

    Article  PubMed  PubMed Central  Google Scholar 

  149. Murphy DF, Greene WB, Dameron TB Jr. Displaced olecranon fracture in adults: clinical evaluation. Clin Orthop Relat Res. 1987;(224):215–23.

    Google Scholar 

  150. Villanueva P, Osorio F, Commessatti M, et al. Tension-band wiring for olecranon fractures: analysis of risk factors for failure. J Shoulder Elb Surg. 2006;15(3):351–6.

    Article  Google Scholar 

  151. Jaberg H, Warner JJ, Jakob RP. Percutaneous stabilization of unstable fractures of the humerus. J Bone Joint Surg Am. 1992;74:508–15.

    Article  CAS  PubMed  Google Scholar 

  152. Browner BD, Jupiter JB, Levine AM, et al., editors. Chapter 42. Trauma to the adult elbow. In: Skeletal trauma, vol. 2 4th ed Elsevier. Philadelphia, PA p. 1542.

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Cody Hillin, G. Russell Huffman, Samir Mehta & Andrew F. Kuntz

  2. Washington Orthopaedics and Sports Medicine, Washington, DC, USA

    J. Stuart Melvin

  3. Concord Orthopaedics, Concord, NH, USA

    Karen Boselli

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  1. Cody Hillin
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  2. J. Stuart Melvin
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  3. Karen Boselli
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  4. G. Russell Huffman
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  6. Andrew F. Kuntz
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  1. Chair, Geriatric Medicine and Gerontology, Robert and Arlene Kogod Professor of Geriatric Medicine, Department of Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota, USA

    Robert J. Pignolo

  2. Co-Director, Orthopaedic Trauma & Fracture Reconstruction, Advisory Dean, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Jaimo Ahn

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Hillin, C., Melvin, J.S., Boselli, K., Huffman, G.R., Mehta, S., Kuntz, A.F. (2018). Fractures of the Shoulder and Elbow. In: Pignolo, R., Ahn, J. (eds) Fractures in the Elderly. Aging Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-72228-3_10

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