Complex Shoulder Fractures New Castle 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:
Devendra Madhusudan Jani, MD
(856) 678-2249
245 N River Dr
Pennsville, NJ
Specialties
Orthopedics
Gender
Male
Education
Medical School: Bj Med Coll, Gujarat Univ, Ahmedabad, Gujarat, India
Graduation Year: 1971

Data Provided By:
S Jayakumar, MD
(302) 651-5911
PO Box 269
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Madras Med Coll, Dr M G R Med Univ, Madras, Tn, India
Graduation Year: 1959

Data Provided By:
Errol Ger, MD
(302) 655-9494
7th & Clayton Sts Medical Service Bldg Ste 600
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Cape Town, Fac Of Med, Cape Town, So Africa
Graduation Year: 1966

Data Provided By:
Peter B Gabos, MD
(302) 651-5740
PO Box 269
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: New York Univ Sch Of Med, New York Ny 10016
Graduation Year: 1991

Data Provided By:
G Dean MacEwen, MD
(215) 427-3412
New Castle, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Queens Univ, Fac Of Med, Kingston, Ont, Canada
Graduation Year: 1953

Data Provided By:
James Richard Bowen, MD
(302) 651-5723
PO Box 269
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Univ Of Sc Coll Of Med, Charleston Sc 29425
Graduation Year: 1971

Data Provided By:
Morgan Kalman Clinic
Wilmington, DE
Specialty
orthopaedic clinic

Data Provided By:
Casscells & Solacoff Orthopaedics & Sports Medicine
Wilmington, DE
Specialty
orthopaedic clinic

Data Provided By:
Richard Titus D'Alonzo, MD
(302) 655-9494
6th and Clayton St Ste 600
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Va Sch Of Med, Charlottesville Va 22908
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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