Shoulder Fracture Fixation

Description:

Most cases involve plate and screw fixation through an open approach.

A sling is applied with a bodybelt. The sling must be worn for 6 weeks – 3 weeks under clothes with the bodybelt, then 3 weeks outside of clothes with the bodybelt removed. They may return to light activities and driving 6 weeks post-op and contact sports 3 months post-op.

Complications:

General Complications <5%:

  • Stiffness
  • Infection
  • Bleeding
  • Failure of fixation
  • Non-union
  • Malunion
  • Complications related to the Interscalene Block

Specific Complications:

  1. Clavicle ORIF:
    1. Reduced sensation around wound – 10% (due to injury to the superficial supraclavicular nerves) [1]
    2. Plate may require removal - >50% [1]
  2. Proximal Humerus ORIF -
    1. AVN of humeral head – not known, but higher for 3 or 4 part fractures and fracture-dislocations [2,3,4].
  3. Humeral Shaft Internal Fixation / Intramedullary Nail – click here [5]

Links:

  1.  Plate fixation of fresh displaced midshaft clavicle fractures
  2. A new locking plate for unstable fractures of the proximal humerus.
  3. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus
  4. PHILOS Plate fixation for displaced fractures of the Proximal Humerus
  5. Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail: A PROSPECTIVE, RANDOMISED TRIAL