Please take your painkillers regularly and begin them before your nerve block wears off. Care is taken during surgery to avoid this, but it can still occur in about 10% of cases and may require implant removal What is my recovery after surgery? Prominent metalwork – if your fracture collapses down around your screws, they may end up perforating the bone of the humeral head and rub in your shoulder joint. The overall rate of this is about 10%, but certain fracture patterns disrupt the blood supply to the humeral head and make this more likely. This is unpredictable in hemiarthroplasty but succeeds in 80% of reverse shoulder replacements after trauma.Ĭollapse and arthritis of the humeral head. If you've had a replacement, best function relies on healing of the tuberosities (lumps of bone that sere as attachments for your rotator cuff tendons). Sometimes patients require revision surgery. 2-3%), which sometimes requires further surgery and antibiotic therapyįailure of bony healing, or fixation failure - if the bone quality is very poor and the fracture collapses before uniting, or the blood supply has been damaged by the injury, this may be very likely. Infection – as for all surgery, there is a small chance of infection (approx. It is rare for these to get injured during your operation, but if they do get injured, it is normally through stretching, rather than being cut, and they therefore normally recover Nerve injury – several nerves pass close to your shoulder and proximal humerus. What are the risks of proximal humerus fracture surgery?Īlthough major complications are rare, proximal humeral fracture surgery can be challenging.īleeding – major bleeding is very rare but occasionally you might need a top-up transfusion after surgery You will wake up with a sling and your arm may be numb from the nerve block. You will need to stay in overnight after your operation. Shoulder fracture surgery is performed under general anaesthesia +/- regional nerve block. A reverse shoulder prosthesis normally provides more reliable outcomes than a half-shoulder replacement (hemiarthroplasty) in trauma. Like many joint replacements, it is generally avoided in patients under 65 years of age. Shoulder replacement is sometimes required to reconstruct a very damaged shoulder, or a complex fracture in a patient with weak bone and poor soft tissue quality. For some patients and fracture patterns this represents the best way of fixing the fracture. This is normally done through a small (3cm) incision over the side of your shoulder. ![]() ![]() Intramedullary nail devices are sometimes used, rather than a plate. This is performed through a small (5cm) incision over the side of your shoulder. Suture repair and the use of bone anchors may be indicated in certain fracture types, generally where only a part of the humerus (greater tuberosity) has been pulled off by the rotator cuff tendons. opposite - intra-operative x-ray of a specific proximal humerus plate) This is performed through a 12cm incision over the front of your shoulder (fig. Plate and screw fixation is used for most proximal humerus fixations. ![]() Surgery for a proximal humerus fracture can include: suture anchor fixation, plate and screw fixation, intramedullary nail or joint replacement.
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