Complex Shoulder Fractures Gillette WY

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Daniel L Morin, DDS
(307) 686-5665
805 S 4J Rd Ste A
Gillette, WY
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Nathan S Simpson
(307) 686-1413
508 Stocktrail Ave
Gillette, WY
Specialty
Orthopedic Surgery

Data Provided By:
Nathan S Simpson, MD
(307) 686-1413
508 Stocktrail Ave Ste A
Gillette, WY
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tx Med Sch At San Antonio, San Antonio Tx 78284
Graduation Year: 1992

Data Provided By:
Monica Leigh Morman, MD
(307) 686-1413
508 Stocktrail Ave Ste A
Gillette, WY
Specialties
Orthopedics
Gender
Female
Education
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduation Year: 1997

Data Provided By:
Hans C Kioschos, MD
(307) 686-1413
1402 W 4th St
Gillette, WY
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1992

Data Provided By:
Joseph Forrest Allegretto
(307) 682-6222
109 W Lakeway Rd
Gillette, WY
Specialty
Orthopedic Surgery

Data Provided By:
John P Dunn
(307) 686-1413
508 Stocktrail Ave
Gillette, WY
Specialty
Orthopedic Surgery

Data Provided By:
Hans C Kioschos
(307) 686-1413
508 Stocktrail Ave
Gillette, WY
Specialty
Orthopedic Surgery

Data Provided By:
John Patrick Dunn, MD
508 Stocktrail Ave Ste A
Gillette, WY
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mi State Univ Coll Of Human Med, East Lansing Mi 48824
Graduation Year: 1995

Data Provided By:
Gerald L Baker
(307) 686-1413
508 Stocktrail Ave
Gillette, WY
Specialty
Orthopedic Surgery

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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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