体育相关的英文文献.pdfVIP

Hindawi Publishing Corporation Advances in Orthopedics Volume 2012, Article ID 861598, 10 pages doi:10.1155/2012/861598 Review Article Evaluation and Management of Proximal Humerus Fractures Ekaterina Khmelnitskaya, Lauren E. Lamont, Samuel A. Taylor, Dean G. Lorich, David M. Dines, and Joshua S. Dines Sports Medicine and Shoulder Service, Orthopaedic Trauma Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA Correspondence should be addressed to Ekaterina Khmelnitskaya, khmelnitskayae@hss.edu Received 28 August 2012; Revised 12 November 2012; Accepted 12 November 2012 Academic Editor: Robert Gillespie Copyright ? 2012 Ekaterina Khmelnitskaya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Proximal humerus fractures are common injuries, especially among older osteoporotic women. Restoration of function requires a thorough understanding of the neurovascular, musculotendinous, and bony anatomy. This paper addresses the relevant anatomy and highlights various management options, including indication for arthroplasty. In the vast majority of cases, proximal humerus fractures may be treated nonoperatively. In the case of displaced fractures, when surgical intervention may be pursued, numerous constructs have been investigated. Of these, the proximal humerus locking plate is the most widely used. Arthroplasty is generally reserved for comminuted 4-part fractures, head-split fractures, or fractures with signi?cant underlying arthritic changes. Reverse total shoulder arthroplasty is reserved for patients with a de?cient rotator cu?, or highly comminuted tuberosities. 1. Introduction