Evaluation of the osteoporotic proximal humeral fracture and strategies for structural augmentation during surgical treatment

Surena Namdari, Pramod B. Voleti, Samir Mehta

Research output: Contribution to journalReview article

17 Scopus citations

Abstract

Fractures of the proximal humerus are relatively common injuries in the elderly population. Given the association between proximal humeral fractures and osteoporosis, elderly patients who sustain these injuries should always undergo a fragility fracture workup. Furthermore, a preoperative assessment of local bone quality can be critical in facilitating decision making regarding surgical and nonsurgical treatment. Modalities for quantifying osteoporosis in the proximal humerus include plain radiography and spiral computed tomography imaging. Optimal management of osteoporotic proximal humeral fractures has evolved and may now includes use of locking plates and augmentation with intramedullary fibular grafts, calcium phosphate or sulfate cement, and iliac crest bone graft. This article reviews the demographics of patients who sustain proximal humerus fractures, the appropriate postinjury fragility fracture workup, modalities for quantifying osteoporosis in the proximal humerus, techniques for augmenting fixation of proximal humerus fractures, and the authors' preferred approach to the treatment of these injuries.

Original languageEnglish (US)
Pages (from-to)1787-1795
Number of pages9
JournalJournal of Shoulder and Elbow Surgery
Volume21
Issue number12
DOIs
Publication statusPublished - Dec 1 2012
Externally publishedYes

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Keywords

  • Augmentation
  • Bone mineral density
  • Osteoporosis
  • Proximal humerus fracture

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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