Abstract
Most complex humeral head fractures are associated with a longitudinal tear of the
rotator cuff. Reconstruction of this tear is frequently omitted from surgical reduction
and fixation procedures. In 48 patients treated by surgery or by conservative means,
we investigated the relationship between rotator cuff integrity and the functional
results. The rotator cuff was assessed by ultrasonography, the functional results
by the Constant Score. Common signs of rotator cuff alterations were partial or complete
atrophy. In all patients affected, a longitudinal defect located at the rotator interval
was detected. A classification of rotator cuff alterations resulting from humeral
head fractures was introduced, yielding three categories: none, moderate, or severe.
In three patients, sonographic results were confirmed by magnetic resonance imaging
(MRI). Rotator cuff alterations were often associated with displaced consolidation
results. Furthermore, the integrity of the rotator cuff significantly correlated with
the function achieved. The results support the need for a careful rotator cuff repair
in order to optimise treatment results.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
Hägg O, Lundberg B. Aspects of prognostic factors in comminuted and dislocated proximal humeral fractures. In: Bateman JE, Welsh RP, editors. Surgery of the Shoulder. Philadelphia: BC Decker Inc., 1984. p. 51–59.
- Internal fixation techniques for proximal humeral fractures.Clin. Orthop. Relat. Res. 1987; 223: 77-85
- Conservative and operative treatment of fractures of the proximal humerus.Unfallchirurg. 1991; 94: 438-446
- Operative treatment of dislocated humerus fractures.Orthopäde. 1992; 21: 121-130
- Results of surgical treatment of multifragmented fractures of the humeral head.Arch. Orthop. Trauma. Surg. 1982; 100: 249-259
- Displaced proximal humeral fractures. Part II. Treatment of three-part and four-part displacement.J. Bone Joint Surg. 1970; 52: 1090-1103
- Comminuted fractures of the proximal humerus.Clin. Orthop. Relat. Res. 1988; 230: 49-57
- Displaced proximal humeral fractures. Part I. Classification and evaluation.J. Bone Joint Surg. 1970; 52A: 1077-1089
Müller ME, Nazarian S, Koch P, Schatzker J. The comprehensive classification of fractures of long bones. Berlin: Springer, 1990.
- A clinical method of functional assessment of the shoulder.Clin. Orthop. Relat. Res. 1987; 214: 160-164
- Prosthetic arthroplasty for fractures and fracture-dislocations of the proximal humerus.Clin. Orthop. Relat. Res. 1983; 179: 116-128
- Replacement arthroplasty and treatment alternatives for old fractures of the humeral head.Orthopäde. 1992; 21: 148-157
Article info
Publication history
Accepted:
April 11,
2002
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
