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Simple and Complex Fractures of the Humerus pp 175–185Cite as

Fracture-Dislocations

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Abstract

Fracture-dislocations of the shoulder are very rare, especially the posterior type. The authors report the clinical and radiographic aspects necessary to approach these injuries. According to Neer, these fractures are divided into anterior or posterior with two, three, or four parts. They are often associated with vascular and nerve injuries especially in the elderly. Accurate X-rays and CT scans are crucial for treatment and to avoid complications. Reconstructive surgery with open reduction and internal fixation is indicated in two- and three-part forms, whereas treatment remains a challenge in four-part fractures. The authors report a new revisited treatment-related classification of four-part fractures based on the study of the calcar, defined as the “missing fifth fragment.” Reduction and fixation should always be attempted in young subjects. Implant of an anatomic humeral prosthesis is indicated in patients with an intact rotator cuff, whereas reverse prosthesis is indicated in subjects over 70 years. This new interpretation may help surgeons to understand each case and may guide the treatment decision. The authors report their original surgical technique defined as “block-bridge” that enables reconstruction even in very difficult cases.

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Acknowledgments

We thank Jean Ann Gilder (Scientific Communication srl., Naples, Italy) for revising and editing the text.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Ospedale dei Pellegrini, Via Portamedina 41, Napoli, 80134, Italy

    Raffaele Russo MD, PhD, Fabio Cautiero MD, Alberto Fontanarosa MD & Giuseppe Della Rotonda MD

Authors
  1. Raffaele Russo MD, PhD
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  2. Fabio Cautiero MD
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  3. Alberto Fontanarosa MD
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  4. Giuseppe Della Rotonda MD
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Corresponding author

Correspondence to Raffaele Russo MD, PhD .

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Editors and Affiliations

  1. Department of Orthopaedics and Traumatology, CTO Hospital Turin, Turin, Italy

    Filippo Castoldi

  2. Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, Turin, Italy

    Davide Blonna

  3. Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, Turin, Italy

    Marco Assom

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Russo, R., Cautiero, F., Fontanarosa, A., Rotonda, G.D. (2015). Fracture-Dislocations. In: Castoldi, F., Blonna, D., Assom, M. (eds) Simple and Complex Fractures of the Humerus. Springer, Milano. https://doi.org/10.1007/978-88-470-5307-6_15

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  • DOI: https://doi.org/10.1007/978-88-470-5307-6_15

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5306-9

  • Online ISBN: 978-88-470-5307-6

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