Is serial radiological evaluation of one-part proximal humeral fractures necessary?
The Bone & Joint Journal Oct 10, 2019
Jacxsens M, et al. - All individuals (n = 100) with an isolated, nonoperatively treated one-part proximal humerus fracture were prospectively followed up between January 2014 and April 2016 in order to ascertain whether and for whom serial radiological assessment was required in one-part proximal humerus fractures, researchers set out to define the clinical history and predictors of secondary displacement in individuals sustaining these injuries. A total of 91 of the fractures persisted to be stable. In five of nine individuals with secondary displacement, surgery was suggested. Comminution, present in 23 individuals, was recognized as a prognosticator of secondary displacement. Individuals’ age, gender, fracture configuration, and bone quality were not related to secondary displacement. Thus, in patients presenting with comminution, radiological re-assessment was only necessary and could be unnecessary for 77% of individuals with one-part proximal humerus fractures. Moreover, with a low rate of secondary surgery, a high union rate, and good clinical outcomes, nonoperative treatment of one-part proximal humerus fractures continues to be the pillar of treatment.
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