February 20, 2015
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Conservative treatment of proximal humerus fracture may lead to settlement at head-shaft junction

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When treated conservatively, proximal humerus fractures settle at the head-shaft junction during healing, according to researchers.

Eighty-nine patients with proximal humerus fractures underwent 6 weeks of sling immobilization and a home-based program rehabilitation protocol started 2 weeks after injury. The researchers obtained standardized radiographs and CT scans of all injured shoulders. Additionally, the researchers performed 42 computer-assisted measurements of displacement and analyzed factors related to progression of displacement.

Results showed 90% of fractures were classified as either posteromedial impaction, lateral impaction, isolated greater tuberosity or anteromedial impaction.

The researchers observed an increase in head-shaft displacement overtime. Average fracture settling in posteromedial impaction fractures included 9° in varus, 7° in retroversion and 3.2 mm in posterior shortening, whereas a decrease in valgus tilt and a tendency toward a more anterior orientation of the articular surface was observed in valgus-impacted fractures. In fewer than 20% of cases, greater tuberosity displacement increased by more than 5 mm.

Results showed progression of displacement was related to age and initial displacement, according to the researchers. – by Casey Tingle

Disclosures: The researchers report no relevant financial disclosures.