Complex Shoulder Fractures Sparks NV

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Kevin J Andrews, DDS
(775) 674-1444
2125 Green Vista Dr Ste 104
Sparks, NV
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
William Richard Ford Jr, MD
(775) 359-5757
2345 E Prater Way Ste 303
Sparks, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Loma Linda Univ Sch Of Med, Loma Linda Ca 92350
Graduation Year: 1966

Data Provided By:
Mario E Porras, MD
(775) 358-1050
2005 Silverada Blvd Ste 110
Reno, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Nm Sch Of Med, Albuquerque Nm 87131
Graduation Year: 1971

Data Provided By:
Thomas Michael Fyda, MD
(775) 786-1444
845 Aitken St
Reno, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Duke Univ Sch Of Med, Durham Nc 27710
Graduation Year: 1991

Data Provided By:
Digby Maxwell Preston
(775) 786-3380
75 Pringle Way
Reno, NV
Specialty
Orthopedic Surgery, Orthopaedic Surgery of the Spine

Data Provided By:
David W Welmerink, DDS
(775) 358-6320
1155 Prater Way
Sparks, NV
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Jeffrey Welling Mast, MD
(775) 359-5757
2345 E Prater Way Ste 303
Sparks, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 1967

Data Provided By:
Everett V Cunningham III, MD
(775) 786-1444
845 Aitken St
Reno, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1970

Data Provided By:
Stephen D Dow
(775) 329-8423
85 Kirman Ave
Reno, NV
Specialty
Orthopedic Surgery

Data Provided By:
Richard Viets Davis
(775) 786-3380
75 Pringle Way
Reno, NV
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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