Complex Shoulder Fractures Claymont DE

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David T Sowa, MD
(302) 731-2888
4745 Ogletown Stanton Rd
Newark, DE
Business
First State Orthopaedics PA
Specialties
Orthopedics

Data Provided By:
Guy Michael Nardella
(302) 478-5800
2004 Foulk Rd
Wilmington, DE
Specialty
Hand Surgery

Data Provided By:
Alfred De Prophetis, DDS
(610) 459-4523
1440 Conchester Hwy
Boothwyn, PA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
John Nista, DMD
(302) 475-4102
1405 Silverside Rd
Wilmington, DE
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Clifford L Anzilotti Sr, DDS
(302) 475-2050
2101 Foulk Rd
Wilmington, DE
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Robert E Booth Jr., MD
(215) 829-2222
800 Spruce St
Philadelphia, PA
Business
3 B Orthopaedics
Specialties
Orthopedics

Data Provided By:
Craig D Morgan, MD
(302) 529-5500
2501 Silverside Rd
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Emory Univ Sch Of Med, Atlanta Ga 30322
Graduation Year: 1977

Data Provided By:
Craig Gordon Smucker
(302) 529-5500
2501 Silverside Rd
Wilmington, DE
Specialty
Adult Reconstructive Orthopaedic Surgery

Data Provided By:
Robert Michael McClellan
(302) 478-5800
2004 Foulk Rd
Wilmington, DE
Specialty
Hand Surgery

Data Provided By:
David Charles Stephens, MD
(302) 478-8601
2700 Silverside Rd Ste 1A
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Suny At Buffalo Sch Of Med & Biomedical Sci, Buffalo Ny 14214
Graduation Year: 1967

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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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