In approximately 20% of cases, surgical therapy is required (see also under further notes).
1st order, depending on the exact form of the fracture.
- Osteosynthesis – surgical procedure to treat fractures (broken bones) and other bone injuries (e.g., epiphysiolyses) to quickly restore full function. This is done by implants (by means of insertion of force carriers such as screws or plates).
- Closed reduction (bringing back to a (near) normal position or normal position) and an ascending, usually unilateral (one-sided) nailing – standard procedure for a proximal humerus fracture (bone fracture of the portion of the humerus close to the trunk).
- Joint prosthesis – depending on the severity of injury.
Osteosynthesis is indicated for the following conditions:
- Axis deviation > 45 °
- Dislocation > 5 mm
- Luxation fracture
- Open fracture
- Comminuted fractures – may need to implant a shoulder joint endoprosthesis.
- For concomitant injuries
Further notes
- Long-term immobilization should be avoided because of the risk of frozen shoulder! A short-term immobilization is a period of one to 2 weeks with subsequent physiotherapy.
- In a study (average age about 66 years), it was demonstrated that surgical treatment of a dislocated proximal humerus fracture (fracture of the humerus) does not achieve better results than conservative treatment. Proximal humerus fractures occur preferentially in the older population. Women are affected approximately two to three times more often than men.
- In older patients, dislocated humeral head fractures heal as well with conservative treatment as after surgical treatment with a Philos plate.Note: Humeral head fractures are the third most common fractures in patients older than 60 years.
