Open AccessIndications and results of osteosynthesis for proximal humerus fragility fractures in elderly patients
Author(s) -
Luigi Murena,
Gianluca Canton,
Chiara Ratti,
Bramir Hoxhaj,
Gioia Giraldi,
Michele Francesco Surace,
Federico Alberto Grassi
Publication year - 2020
Publication title -
orthopedic reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.412
H-Index - 13
eISSN - 2035-8237
pISSN - 2035-8164
DOI - 10.4081/or.2020.8559
Subject(s) - medicine , osteosynthesis , proximal humerus , osteoporosis , rehabilitation , surgery , conservative treatment , fragility , population , humerus , orthopedic surgery , general surgery , physical therapy , chemistry , environmental health
Proximal humerus fractures (PHF) are common injuries in the elderly population. Conservative treatment is indicated for undisplaced and stable fractures, which account for almost 80% of the cases. More complex fracture patterns might need surgery, with a wide variety of indication criteria and surgical techniques described in the literature. Surgical treatment should be reserved for patients in good clinical conditions, autonomous in daily living activities and able to adhere to postoperative rehabilitation protocols. In the elderly population with severe osteoporosis, cognitive impairment and clinical comorbidities, the risk of surgical failures is high. In these patients, the choice between surgical and conservative treatment, as well as for the type of procedure, is even more difficult, with no general consensus in the literature. Final indication is usually conditioned by surgeon’s experience and preference. Two independent reviewers (B.H and G.G) independently extracted studies on proximal humeral fractures. All selected studies were screened independently (B.H and G.G) based on title and abstract. Then the full text of any article that either judged potentially eligible was acquired and reviewed again. Any disagreement was resolved by discussing the full text manuscripts. Aim of the present paper is to review the literature about indications and results of osteosynthesis for proximal humerus fragility fractures in the elderly population.