Dataset Information

Management of displaced humeral surgical neck fractures in daily clinical practice: hanging does not re-align the fracture.

ABSTRACT:

Introduction

It is unclear if the collar and cuff treatment improve alignment in displaced surgical neck fractures of the proximal humerus. Therefore, this study evaluated if the neckshaft angle and extent of displacement would improve between trauma and onset of radiographically visible callus in non-operatively treated surgical neck fractures (Boileau type A, B, C).

Materials and methods

A consecutive series of patients (≥ 18 years old) were retrospectively evaluated from a level 1 trauma center in Australia (inclusion period: 2016-2020) and a level 2 trauma center in the Netherlands (inclusion period: 2004 to 2018). Patients were included if they sustained a Boileau-type fracture and underwent initial non-operative treatment. The first radiograph had to be obtained within 24 h after the initial injury and the follow-up radiograph(s) 1 week after trauma and before the start of radiographically visible callus. On each radiograph, the maximal medial gap (MMG), maximal lateral gap (MLG), and neck-shaft angle (NSA) were measured. Linear mixed modelling was performed to evaluate if these measurements would improve over time.

Results

Sixty-seven patients were included: 25 type A, 11 type B, and 31 type C fractures. The mean age (range) was 68 years (24-93), and the mean number (range) of follow-up radiographs per patient was 1 (1-4). Linear mixed modelling on both MMG and MLG revealed no improvement during follow-up among the three groups. Mean NSA of type A fractures improved significantly from 161° at trauma to 152° at last follow-up (p-value = 0.004).

Conclusions

Apart from humeral head angulation improvement in type A, there is no increase nor reduction in displacement among the three fracture patterns. Therefore, it is advised that surgical decision-making should be performed immediately after trauma.

Level of clinical evidence

Level IV, retrospective case series.

SUBMITTER: Spek RWA

PROVIDER: S-EPMC10191947 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Management of displaced humeral surgical neck fractures in daily clinical practice: hanging does not re-align the fracture.

Spek Reinier W A RWA Hoogervorst Lotje A LA Elias Michaëla E C MEC Jaarsma Ruurd L RL Veeger DirkJan H E J DHEJ Doornberg Job N JN Jutte Paul C PC van den Bekerom Michel P J MPJ

Archives of orthopaedic and trauma surgery 20220716 6

<h4>Introduction</h4>It is unclear if the collar and cuff treatment improve alignment in displaced surgical neck fractures of the proximal humerus. Therefore, this study evaluated if the neckshaft angle and extent of displacement would improve between trauma and onset of radiographically visible callus in non-operatively treated surgical neck fractures (Boileau type A, B, C).<h4>Materials and methods</h4>A consecutive series of patients (≥ 18 years old) were retrospectively evaluated from a leve ...[more]

PMID: 35840714

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Dataset Information

Management of displaced humeral surgical neck fractures in daily clinical practice: hanging does not re-align the fracture.

Introduction

Materials and methods

Results

Conclusions

Level of clinical evidence

Publications

Management of displaced humeral surgical neck fractures in daily clinical practice: hanging does not re-align the fracture.

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