Complex Shoulder Fractures Lafayette CO

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Peter P Chiang
(303) 861-3408
280 Exempla Cir
Lafayette, CO
Specialty
Orthopedic Surgery

Data Provided By:
Tracy S Pursley
(720) 536-7116
280 Exempla Cir
Lafayette, CO
Specialty
Orthopedic Surgery

Data Provided By:
Peter Peider Chiang, MD
(303) 665-1845
280 Exempla Cir
Lafayette, CO
Specialties
Orthopedics
Gender
Male
Education
Medical School: In Univ Sch Of Med, Indianapolis In 46202
Graduation Year: 1997

Data Provided By:
Ruth B Nauts
(303) 743-5855
280 Exempla Cir
Lafayette, CO
Specialty
Orthopedic Surgery

Data Provided By:
Jeffrey M Hrutkay, MD
2246 Eagles Nest Dr
Lafayette, CO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Uniformed Services Univ Of The Hlth Sci, Bethesda Md 20814
Graduation Year: 1984

Data Provided By:
Robert A Craig, DDS
(303) 428-8800
1120 W South Boulder Rd #201
Lafayette, CO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
DiMitrios J Zaronias
(303) 861-3408
280 Exempla Cir
Lafayette, CO
Specialty
Orthopedic Surgery

Data Provided By:
Leo Stelzer
(303) 861-3408
280 Exempla Cir
Lafayette, CO
Specialty
Hand Surgery

Data Provided By:
Julie Anne Melchior, MD
(720) 536-7125
280 Exempla Cir
Lafayette, CO
Specialties
Orthopedics, Hand Surgery
Gender
Female
Education
Medical School: Northwestern Univ Med Sch, Chicago Il 60611
Graduation Year: 1991

Data Provided By:
J David Grauer, MD
(303) 665-0286
80 Health Park Dr Ste 270
Louisville, CO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Case Western Reserve Univ Sch Of Med, Cleveland Oh 44106
Graduation Year: 1982

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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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