Complex Shoulder Fractures Danville VA

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Stuart J Kramer
(434) 793-4711
125 Executive Dr
Danville, VA
Specialty
Orthopedic Surgery

Data Provided By:
Lawrence F Cohen
(434) 792-6326
150 W Main St
Danville, VA
Specialty
Orthopedic Surgery

Data Provided By:
Jonathan Krome
(434) 793-4711
125 Executive Dr
Danville, VA
Specialty
Orthopedic Surgery

Data Provided By:
Stuart Jeffrey Kramer, MD
(434) 793-4711
125 Executive Dr
Danville, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Suny-Hlth Sci Ctr At Syracuse, Coll Of Med, Syracuse Ny 13210
Graduation Year: 1981

Data Provided By:
Mark C Hermann
(434) 793-4711
125 Executive Dr
Danville, VA
Specialty
Orthopedic Surgery

Data Provided By:
Joseph C Campbell Jr, MD
(434) 793-4711
125 Executive Dr
Danville, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Va Sch Of Med, Charlottesville Va 22908
Graduation Year: 1990

Data Provided By:
Robert Edward Cassidy, MD
(434) 793-0900
110 Exchange St
Danville, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Georgetown Univ Sch Of Med, Washington Dc 20007
Graduation Year: 1966

Data Provided By:
Ada Cheung, MD
(602) 274-5459
125 Executive Dr Ste A
Danville, VA
Specialties
Orthopedics
Gender
Female
Education
Medical School: Yale Univ Sch Of Med, New Haven Ct 06510
Graduation Year: 1992

Data Provided By:
Mark Christopher Hermann, MD
(434) 793-4711
125 Executive Dr
Danville, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Georgetown Univ Sch Of Med, Washington Dc 20007
Graduation Year: 1985

Data Provided By:
Walter B Shepherd, DDS
(434) 792-0141
808 Piney Forest Rd
Danville, VA
Specialties
Orthodontics/Dentofacial Orthopedics

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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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