Complex Shoulder Fractures Chapel Hill NC

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Atulkumar B Joshi, MD
(806) 797-9119
Chapel Hill, NC
Specialties
Orthopedics
Gender
Male
Education
Medical School: Topiwala Nat'L Med Coll, Univ Of Bombay, Bombay, Maharashtra, India
Graduation Year: 1978

Data Provided By:
Kyle Emerson Black Jr, MD
(919) 220-5255
203 Timberhill Pl
Chapel Hill, NC
Specialties
Orthopedics
Gender
Male
Education
Medical School: Bowman Gray Sch Of Med Of Wake Forest Univ, Winston-Salem Nc 27157
Graduation Year: 1978

Data Provided By:
Tammy R Severt, DDS
(919) 929-2365
110 Conner Dr Ste 1
Chapel Hill, NC
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Robert A Creighton, MD
(919) 966-9066
School of Medicine CB 7055 236 Burnett-Womack Bldg,
Chapel Hill, NC
Specialties
Orthopedics
Gender
Male
Education
Medical School: Va Commonwealth Univ, Med Coll Of Va Sch Of Med, Richmond Va 23298
Graduation Year: 1998

Data Provided By:
William Robert Proffit, DDS
(919) 966-4428
University Of Nc Unc Sch Of Dentistry
Chapel Hill, NC
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
David Gregory Brooks, DDS
(910) 892-1054
1802 W Cumberland St
Chapel Hill, NC
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Howard Garland Hershey, DDS
(919) 962-1091
University Of Nc Dept Of Orth 7450 Cb
Chapel Hill, NC
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Dr.ROBERT ESTHER
(919) 962-6637
101 Manning Dr # 7001J
Chapel Hill, NC
Gender
M
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

Data Provided By:
Brandon D Bushnell, MD
(919) 966-9071
3144 Bioinformatics Bldg Campus Box 7055,
Chapel Hill, NC
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Mark R McGinnis, MD
(828) 322-5172
30078 Britt
Chapel Hill, NC
Gender
Male
Education
Medical School: Wv Univ Sch Of Med, Morgantown Wv 26506
Graduation Year: 1984

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Best Way to Surgically Treat Complex Shoulder Fractures

When it comes to complex fractures of the humerus (upper arm) in older adults, surgeons really have their work cut out for them. There are so many things to keep in mind. A complex fracture usually means the bone is broken into three or four parts. Putting the pieces back together in a way that promotes recovery and return to full function can be a real challenge.

The age of the person matters because people over age 70 often have low bone mass and slow healing. The way in which the bone has fractured, the anatomy of the underlying structures, and risk of ischemia (loss of blood supply to the bone) are additional variables to consider. The chances of developing osteonecrosis (death of the bone) increase with each one of these factors.

A very well-known surgeon (Dr. Charles Neer) introduced the idea of replacing the shoulder instead of trying to repair it. That was back in 1970. Since then, surgeons have tried full joint replacement and hemiarthroplasty (replacing only one side of the joint). These methods have proven to work but not always smoothly. Ischemia and osteonecrosis are still major concerns. Pain relief and improvement in function and recovery aren't always guaranteed.

So, experts have gone back to the drawing board to rethink surgical treatment for these complex proximal humeral fractures. Proximal means the break occurred at the top of the shoulder where the round head and of the femur are located. They asked themselves if the results could be improved with better surgical technique.

They have tried developing implants specifically designed for the type of fracture involved. They have studied the anatomy of the joint very carefully trying to mimic it in every way with reconstructive surgery. Achieving optimal anatomical structures involves the structure, shape, angle, length, and orientation of bone, muscle, tendons, ligaments, even fat deposits.

To give you one example of why this is all important -- getting the proper height of the implant in the joint requires restoring the exact shape (contour) of the humerus where some of the muscles attach. Using the other shoulder as a template helps the surgeon reproduce "normal" as much as possible on the operative (fractured) side.

That brings us to the latest efforts in this area. This article reports on the use of reverse shoulder arthroplasty for three- and four-part proximal humeral fractures. The broken pieces are removed and replaced with a prosthesis (artificial joint). In the "normal" shoulder replacement, the socket side of the implant is a shallow plastic piece and the humeral component is a metal stem attached to a metal ball. In the reverse shoulder replacement, the ball and the socket are reversed.

Naturally, when a new technique is tried, the results must be recorded and reported. Studies done so far have been limited with small numbers of patients and short-term results. But so far the results have been more predictable with improved ...

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