Complex Shoulder Fractures Wilmington 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:
Dr.Errol Ger
(302) 427-2370
1207 N Scott St # 4
Wilmington, DE
Gender
M
Education
Medical School: Univ Of Cape Town, Fac Of Med, Cape Town
Year of Graduation: 1966
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

Data Provided By:
Candice Pfeiffer Holden, MD
(302) 658-1955
2612 W 18th St
Wilmington, DE
Specialties
Orthopedics
Gender
Female
Education
Medical School: Univ Of Southern Ca Sch Of Med, Los Angeles Ca 90033
Graduation Year: 1995
Hospital
Hospital: St Christophers Hosp For Child, Philadelphia, Pa

Data Provided By:
Dan Edison Mason, MD
(302) 651-5922
PO Box 269
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Ga Sch Of Med, Augusta Ga 30912
Graduation Year: 1971

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

Data Provided By:
Charles Joseph Veith, DMD
(302) 658-7354
2300 Pennsylvania Ave
Wilmington, DE
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Richard I Clemmer Jr, MD
2401 Pennsylvania Ave
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Jefferson Med Coll-Thos Jefferson Univ, Philadelphia Pa 19107
Graduation Year: 1971

Data Provided By:
Ronald Michael Repice, MD
(610) 874-1500
1010 Concord Ave
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Hahnemann Univ Sch Of Med, Philadelphia Pa 19102
Graduation Year: 1965

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:
Freeman Miller, MD
(302) 651-5921
PO Box 269
Wilmington, DE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Co Sch Of Med, Denver Co 80262
Graduation Year: 1978
Hospital
Hospital: Christiana Hosp, Newark, De; Dupont Hosp For Children, Wilmington, De
Group Practice: Alfred I Dupont Hosp For Chldn

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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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