ShoulderConservative management of proximal humeral fractures: Can poor functional outcome be related to standard transscapular radiographic evaluation?
Section snippets
Materials and methods
The Medical Ethical Committee of the University Hospital Maastricht approved the study protocol (MEC number 08-2-009), and informed consent was obtained from all patients.
Patients
In the period 2003 to 2005, 101 patients underwent conservative treatment for isolated proximal humeral fractures. Of these, 21 patients refused to participate, 9 died, 6 were terminally ill, and 10 had severe dementia, leaving 55 patients (60%) for assessment and analysis.
The mean age of the included patients at the time of the fracture was 70 (SD 10) years (Table I), and 41 (74.5%) were women According to the AO classification 22% of the fractures were A2 type, 69% were B1, and 9% were C1
Discussion
This study investigated whether a radiographic evaluation during conservative treatment of proximal humeral fractures could be used as a predictor of functional outcome. We found that for the individual patient, angulation on the Y view, but not angulation on the glenoid AP view, was predictive of functional outcome.
Although the patients had moderately good overall satisfaction with their functional outcome (mean DASH score of 23), 10 of the 55 patients (18%) had a considerable perceived
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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2018, Journal of the American College of RadiologyCitation Excerpt :Contrast is generally not necessary unless there is concern for arterial injury (see Variant 9). Three-dimensional volume-rendered CT images may be obtained to better characterize fracture patterns and humeral neck angulation, which can affect functional outcomes [41]. Arthrography is not routinely performed in conjunction with CT in the evaluation of proximal humeral fractures.
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2016, InjuryCitation Excerpt :However, in non-operative treatment mean saCS was better in anatomical fracture healing, like also shown in other studies [25,26]. Interestingly, Poeze et al. showed that only radiographic results in Y-view correlate with functional outcome, not radiographic results in AP-view [27]. It remains open, which other factors next to anatomic fracture healing and adequate physiotherapy influence the functional outcome in proximal humeral fractures.
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