Skip to main content
SpringerLink
Log in

Proximal Humeral Fractures

  • Chapter
  • First Online:
Bone and Joint Injuries

Part of the book series: European Manual of Medicine ((EUROMANUAL))

  • 2288 Accesses

Abstract

Proximal humeral fractures are quite frequent, especially in elderly females with osteopenic bone structure. With precise diagnostics and a consequent classification of the fracture, it is possible to define an individual treatment protocol. In doing so, it is helpful to understand the individual pathomechanisms leading to the fracture pattern that must be addressed. Even today, proximal humeral fractures are treated mostly nonoperatively. Operative treatment is challenging. In order to cover the entire variety of fractures it is necessary to perform all kinds of osteosynthesis, including K-wires, nails, plates, and both anatomic and inverse fracture prostheses.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literature

  1. Court-Brown C, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37(8):691–697

    Article  PubMed  Google Scholar 

  2. Péntek M, Horváth C, Boncz I, Falusi Z, Tóth E, Sebestyén A et al (2008) Epidemiology of osteoporosis related fractures in Hungary from the nationwide health insurance database, 1999–2003. Osteoporos Int 19(2):243–249

    Article  PubMed  Google Scholar 

  3. Palvanen M, Kannus P, Niemi S, Parkkari J (2006) Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res 442(1):87–92

    Article  PubMed  Google Scholar 

  4. Bahrs C, Schmal H, Lingenfelter E, Rolauffs B, Weise K, Dietz K et al (2008) Inter- and intraobserver reliability of the MTM-classification for proximal humeral fractures: a prospective study. BMC Musculoskelet Disord 9:21

    Article  PubMed Central  PubMed  Google Scholar 

  5. Hertel R, Hempfing A, Stiehler M, Leunig M (2004) Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg 13(4):427–433

    Article  CAS  PubMed  Google Scholar 

  6. Majed A, Macleod I, Bull AMJ, Zyto K, Resch H, Hertel R et al (2011) Proximal humeral fracture classification systems revisited. J Shoulder Elbow Surg 20(7):1125–1132

    Article  PubMed  Google Scholar 

  7. Hertel R (2005) Fractures of the proximal humerus in osteoporotic bone. Osteoporos Int 16(Suppl 2):S65–S72

    Article  PubMed  Google Scholar 

  8. Bastian J, Hertel R (2008) Initial post-fracture humeral head ischemia does not predict development of necrosis. J Shoulder Elbow Surg 17(1):2–8

    Article  PubMed  Google Scholar 

  9. Boileau P, Trojani C, Walch G, Krishnan S, Romeo A, Sinnerton R (2001) Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Shoulder Elbow Surg 10(4):299–308

    Article  CAS  PubMed  Google Scholar 

  10. Boileau P, Chuinard C, Le Huec J-C, Walch G, Trojani C (2006) Proximal humerus fracture sequelae: impact of a new radiographic classification on arthroplasty. Clin Orthop Relat Res 442:121–130

    Article  PubMed  Google Scholar 

  11. Court-Brown CM, McQueen MM (2008) Nonunions of the proximal humerus: their prevalence and functional outcome. J Trauma 64(6):1517–1521

    Article  PubMed  Google Scholar 

  12. Court-Brown CM, McQueen M (2009) Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. J Bone Joint Surg Am 91(11):2771; author reply 2771–2772

    PubMed  Google Scholar 

  13. Iyengar JJ, Devcic Z, Sproul RC, Feeley BT (2011) Nonoperative treatment of proximal humerus fractures: a systematic review. J Orthop Trauma 25(10):612–617

    Article  PubMed  Google Scholar 

  14. Fjalestad T, Hole MØ, Jørgensen JJ, Strømsøe K, Kristiansen IS (2010) Health and cost consequences of surgical versus conservative treatment for a comminuted proximal humeral fracture in elderly patients. Injury 41(6):599–605

    Article  CAS  PubMed  Google Scholar 

  15. Olerud P, Ahrengart L, Ponzer S, Saving J, Tidermark J (2011) Internal fixation versus nonoperative treatment of displaced 3-part proximal humeral fractures in elderly patients: a randomized controlled trial. J Shoulder Elbow Surg 20(5):747–755

    Article  PubMed  Google Scholar 

  16. Sanders RJ, Thissen LG, Teepen JC, van Kampen A, Jaarsma RL (2011) Locking plate versus nonsurgical treatment for proximal humeral fractures: better midterm outcome with nonsurgical treatment. J Shoulder Elbow Surg 20(7):1118–1124

    Article  PubMed  Google Scholar 

  17. Jakob R, Miniaci A, Anson P, Jaberg H, Osterwalder A, Ganz R (1991) Four-part valgus impacted fractures of the proximal humerus. J Bone Joint Surg Br 73(2):295–298

    CAS  PubMed  Google Scholar 

  18. Resch H (2011) Proximal humeral fractures: current controversies. J Shoulder Elbow Surg 20(5):827–832

    Article  PubMed  Google Scholar 

  19. Bergmann G, Graichen F, Rohlmann A, Westerhoff P, Bender A, Gabel U et al (2007) Loads acting on orthopaedic implants: measurements and practical applications. Orthopade 36(3):195–204

    Article  CAS  PubMed  Google Scholar 

  20. Ogawa K, Kobayashi S, Ikegami H (2011) Retrograde intramedullary multiple pinning through the deltoid “V” for valgus-impacted four-part fractures of the proximal humerus. J Trauma 71(1):238–244

    Article  PubMed  Google Scholar 

  21. Resch H, Povacz P, Frohlich R, Wambacher M (1997) Percutaneous fixation of three- and four-part fractures of the proximal humerus. J Bone Joint Surg Br 79(2):295–300

    Article  CAS  PubMed  Google Scholar 

  22. Brunner F, Sommer C, Bahrs C, Heuwinkel R, Hafner C, Rillmann P et al (2009) Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma 23(3):163–172

    Article  PubMed  Google Scholar 

  23. Blum J, Hansen M, Rommens PM (2009) Angle-stable intramedullary nailing of proximal humerus fractures with the PHN (proximal humeral nail). Oper Orthop Traumatol 21(3):296–311

    Article  PubMed  Google Scholar 

  24. Lanting B, Macdermid J, Drosdowech D, Faber K (2008) Proximal humeral fractures: a systematic review of treatment modalities. J Shoulder Elbow Surg 17(1):42–54

    Article  PubMed  Google Scholar 

  25. Sudkamp N, Bayer J, Hepp P, Voigt C, Oestern H, Kaab M et al (2009) Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. Results of a prospective, multicenter, observational study. J Bone Joint Surg Am 91(6):1320–1328

    Article  CAS  PubMed  Google Scholar 

  26. Thanasas C, Kontakis G, Angoules A, Limb D, Giannoudis P (2009) Treatment of proximal humerus fractures with locking plates: a systematic review. J Shoulder Elbow Surg 18(6):837–844

    Article  PubMed  Google Scholar 

  27. Fjalestad T, Stromsoe K, Blucher J, Tennoe B (2005) Fractures in the proximal humerus: functional outcome and evaluation of 70 patients treated in hospital. Arch Orthop Trauma Surg 125(5):310–316

    Article  PubMed  Google Scholar 

  28. Krappinger D, Bizzotto N, Riedmann S, Kammerlander C, Hengg C, Kralinger FS (2011) Predicting failure after surgical fixation of proximal humerus fractures. Injury 42(11):1283–1288

    Article  PubMed  Google Scholar 

  29. Sudkamp NP, Audige L, Lambert S, Hertel R, Konrad G (2011) Path analysis of factors for functional outcome at one year in 463 proximal humeral fractures. J Shoulder Elbow Surg 20(8):1207–1216

    Article  PubMed  Google Scholar 

  30. Krappinger D, Roth T, Gschwentner M, Suckert A, Blauth M, Hengg C et al (2012) Preoperative assessment of the cancellous bone mineral density of the proximal humerus using CT data. Skeletal Radiol 41(3):299–304

    Article  PubMed  Google Scholar 

  31. Tingart M, Apreleva M, von Stechow D, Zurakowski D, Warner J (2003) The cortical thickness of the proximal humeral diaphysis predicts bone mineral density of the proximal humerus. J Bone Joint Surg Br 85(4):611–617

    Article  PubMed  Google Scholar 

  32. Bastian J, Hertel R (2009) Osteosynthesis and hemiarthroplasty of fractures of the proximal humerus: outcomes in a consecutive case series. J Shoulder Elbow Surg 18(2):216–219

    Article  PubMed  Google Scholar 

  33. Dietrich M, Meier C, Lattmann T, Zingg U, Gruninger P, Platz A (2008) Complex fracture of the proximal humerus in the elderly. Locking plate osteosynthesis vs hemiarthroplasty. Chirurg 79(3):231–240

    Article  CAS  PubMed  Google Scholar 

  34. Fialka C, Stampfl P, Arbes S, Reuter P, Oberleitner G, Vécsei V (2008) Primary hemiarthroplasty in four-part fractures of the proximal humerus: randomized trial of two different implant systems. J Shoulder Elbow Surg 17(2):210–215

    Article  PubMed  Google Scholar 

  35. Kralinger F, Schwaiger R, Wambacher M, Farrell E, Menth-Chiari W, Lajtai G et al (2004) Outcome after primary hemiarthroplasty for fracture of the head of the humerus. A retrospective multicentre study of 167 patients. J Bone Joint Surg Br 86(2):217–219

    Article  CAS  PubMed  Google Scholar 

  36. Amirfeyz R, Sarangi P (2008) Shoulder hemiarthroplasty for fracture with a conservative rehabilitation regime. Arch Orthop Trauma Surg 128(9):985–988

    Article  PubMed  Google Scholar 

  37. Cazeneuve JF, Cristofari D-J (2010) The reverse shoulder prosthesis in the treatment of fractures of the proximal humerus in the elderly. J Bone Joint Surg Br 92(4):535–539

    Article  CAS  PubMed  Google Scholar 

  38. Klein M, Juschka M, Hinkenjann B, Scherger B, Ostermann PA (2008) Treatment of comminuted fractures of the proximal humerus in elderly patients with the Delta III reverse shoulder prosthesis. J Orthop Trauma 22(10):698–704

    Article  PubMed  Google Scholar 

  39. Gallinet D, Clappaz P, Garbuio P, Tropet Y, Obert L (2009) Three or four parts complex proximal humerus fractures: hemiarthroplasty versus reverse prosthesis: a comparative study of 40 cases. Orthop Traumatol Surg Res 95(1):48–55

    Article  CAS  PubMed  Google Scholar 

  40. Werner C, Steinmann P, Gilbart M, Gerber C (2005) Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am 87(7):1476–1486

    Article  CAS  PubMed  Google Scholar 

  41. Rockwood C (2007) The reverse total shoulder prosthesis. The new kid on the block. J Bone Joint Surg Am 89(2):233–235

    Article  PubMed  Google Scholar 

  42. Boileau P, Watkinson D, Hatzidakis A, Hovorka I (2006) Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg 15(5):527–540

    Article  PubMed  Google Scholar 

  43. Favard L, Levigne C, Nerot C, Gerber C, Wilde L, Mole D (2011) Reverse prostheses in arthropathies with cuff tear: are survivorship and function maintained over time? Clin Orthop Relat Res 469(9):2469–2475

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department Orthopädie und Traumatologie, Universitätsklinikum Freiburg, Hugstetter Strasse 55, Freiburg, 79106, Germany

    Martin Jaeger MD, Kaywan Izadpanah & Norbert P. Südkamp

Authors
  1. Martin Jaeger MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kaywan Izadpanah
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Norbert P. Südkamp
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Jaeger MD .

Editor information

Editors and Affiliations

  1. General Hospital Celle, Celle, Germany

    Hans-Jörg Oestern

  2. University of Zurich Department of Trauma Surgery, Zürich, Switzerland

    Otmar Trentz

  3. Klinische Abt. Allgemeinchirurgie, Medizinische Universität Graz Universitätsklinik für Chirurgie, Graz, Austria

    Selman Uranues

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Jaeger, M., Izadpanah, K., Südkamp, N.P. (2014). Proximal Humeral Fractures. In: Oestern, HJ., Trentz, O., Uranues, S. (eds) Bone and Joint Injuries. European Manual of Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38388-5_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-38388-5_3

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38387-8

  • Online ISBN: 978-3-642-38388-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation