Proximal Humerus Fractures in Osteoporotic Bone

Abstract

Fractures of the proximal humerus are extremely common in adults older than 50 years.Osteoporosis is a common comorbidity in this patient population, particularly in women, and has important implications for the treatment of such fractures. Most osteoporotic fractures of the proximal humerus may be treated with nonsurgical management, with protocols for rehabilitation designed to promote early range of motion and gradual strengthening of the rotator cuff muscles. For displaced fractures of the proximal humerus involving two, three, or four parts, as defined by the Neer classification, surgical management may be indicated. Surgical options for treating osteoporotic fractures of the proximal humerus include the use of locking plate constructs and, for fractures in which reconstruction is not possible, hemiarthroplasty or reverse total shoulder arthroplasty. Appropriate patient selection is essential for optimizing the clinical, radiographic, and functional outcomes of treatment for these challenging fractures.

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