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Presenter: Understand proximal humerus fractures and indications for treatment
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BOSTON — In a presentation about proximal humerus fractures at the American Shoulder and Elbow Surgeons Open Symposium, Bradford O. Parsons, MD, noted it is important for surgeons to understand not only the fracture they are treating, but the indications as well.
“You have got to understand the fracture you are treating and you have got to understand your indications,” Parsons said. “I try to take the time to educate the patient[s] about their options, give them a sense of what I think their function may be with and without surgery.”
In his presentation, Parsons noted surgeons will find the bulk of their information on whether to treat the fracture from good X-rays, with additional information coming from CT scans. He added that while fractures that are severely displaced should be treated operatively, many proximal humerus fractures can be treated nonoperatively with good results.
“Certainly in a varus fracture, [it] is not going to do well to treat it nonoperatively,” Parsons said. “If the tuberosities are displaced, especially above the humeral head, that is going to cause impingement or issues and so I would be more aggressive about those fractures.”
According to Parsons, the goal of the surgery is to restore anatomy.
“It is not enough just to put a lock plate on there when the tuberosity is malpositioned with heavy retroversion,” he said. “That is not going to restore function; so we have got to restore inclination, version and tuberosity relationships.” – by Casey Tingle
Reference:
Parsons BO. Proximal humerus: ORIF. Presented at: American Shoulder and Elbow Surgeons Open Symposium; Oct. 6, 2016; Boston.
Disclosure: Parsons reports he is a paid consultant and paid presenter or speaker for Arthrex Inc. and Zimmer; and is on the editorial or governing board for and receives publishing royalties, financial or material support from the Journal of Bone and Joint Surgery – American.