RESEARCH ARTICLE


Orthopaedic Approaches to Proximal Humeral Fractures Following Trauma



Reza Mafi 1, Wasim Khan 2, Pouya Mafi 3, Sandip Hindocha*, 4
1 Department of Orthopaedic Surgery, Diana Princess of Wales Hospital, Grimsby, DN33 2BA, UK
2 Royal National Orthopaedic Hospital, UK
3 Hull York Medical School, Heslington, York, YO10 5DD, UK
4 Department of Plastic Surgery, Whiston Hospital, Merseyside, L35 5DR, UK


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© Mafi et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Department of Plastic Surgery, Whiston Hospital, Liverpool, UK L35 5DR, UK; Tel: + 44(0)1244366265; Fax: +44(0)1244366265; E-mail: hindocha2001@yahoo.com


Abstract

Proximal humeral fractures have been a topic of discussion in medical literature dating back as far as 3rd century BC. Today, these fractures are the most common type of humeral fractures and account for about 5-6% of all fractures in adults with the incidence rising rapidly with age. In broad terms the management of proximal humeral fractures can be divided into two categories: conservative versus surgical intervention. The aim of treatment is to stabilize the fracture, aid better union and reduce pain during the healing process. Failure to achieve this can result in impairment of function, and significantly weaken the muscles inserting onto the proximal humerus. With the rising incidence of proximal humeral fractures, especially among the elderly, the short and long term burden for patients as well as the wider society is increasing. Furthermore, there is a lack of consistency in the definitive treatment and management of displaced fractures. This systematic review of literature compares the surgical treatment of proximal humeral fractures with their conservative management, by evaluating the available randomised controlled trials on this topic.

Keywords: Bandages, conservative management, fractures, immobilisation, internal fixation, proximal humerus, randomised controlled trial, shoulder fracture, treatment outcome..