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Geriatric proximal humeral fracture patients show similar clinical outcomes to non-geriatric patients after osteosynthesis with endosteal fibular strut allograft augmentation.
Hinds, Richard M; Garner, Matthew R; Tran, Wesley H; Lazaro, Lionel E; Dines, Joshua S; Lorich, Dean G.
Afiliação
  • Hinds RM; Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY, USA. Electronic address: RichardHindsResearch@gmail.com.
  • Garner MR; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
  • Tran WH; Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY, USA.
  • Lazaro LE; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
  • Dines JS; Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
  • Lorich DG; Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY, USA; Orthopaedic Trauma Service, New York Presbyterian Hospital, New York, NY, USA.
J Shoulder Elbow Surg ; 24(6): 889-96, 2015 Jun.
Article em En | MEDLINE | ID: mdl-25483905
BACKGROUND: Osteosynthesis of proximal humeral fractures is challenging in geriatric patients. The purpose of this investigation was to compare postoperative clinical outcomes between cohorts of geriatric (aged ≥65 years) and non-geriatric proximal humeral fracture patients treated via locked plating with endosteal fibular strut allograft augmentation. METHODS: From March 2007 to January 2013, 71 adult patients with 2-, 3-, and 4-part proximal humeral fractures according to the Neer classification underwent osteosynthesis with locked plating and fibular allograft augmentation and had at least 12 months of clinical follow-up. All patients followed the same postoperative rehabilitation protocol. We compared the following between geriatric and non-geriatric patients: Disabilities of the Arm, Shoulder and Hand scores; University of California, Los Angeles shoulder ratings; Constant-Murley scores; and range of motion; as well as injury characteristics and radiographic outcomes. RESULTS: Geriatric patients comprised 48% of the study cohort (34 of 71 patients). The mean age of the geriatric and non-geriatric cohorts was 74 years and 53 years, respectively. Geriatric patients showed significantly reduced forward flexion (147° vs 159°, P = .04) when compared with non-geriatric patients. There were no significant differences in functional scores, radiographic outcomes, or complication rates between the 2 cohorts, although in 1 geriatric patient, osteonecrosis developed and screw penetration through the collapsed head was present 3 years after surgery. CONCLUSIONS: Osteosynthesis of proximal humeral fractures via locked plating with fibular strut allograft augmentation results in similar clinical outcomes between geriatric and non-geriatric patients. We believe that enhanced stability provided by this fixation construct allows early intensive postoperative therapy and results in excellent outcomes despite patient age.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas do Ombro / Articulação do Ombro / Fíbula / Fixação Interna de Fraturas Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas do Ombro / Articulação do Ombro / Fíbula / Fixação Interna de Fraturas Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article