Current concepts in the treatment of proximal humerus nonunions: a review
Objective: To review contemporary concepts regarding the etiology, classifications, and treatment of nonunion following proximal humerus fractures (PHFs). Materials and Methods: For the arrangement of this narrative non-systematic review, an exploratory search in the MEDLINE (via PubMed) database...
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Bulgarian Orthopaedics and Trauma Association
2025-04-01
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| Series: | Journal of the Bulgarian Orthopaedics and Trauma Association |
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| Online Access: | https://www.jbota.org/index.php/jbota/article/view/160 |
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| author | Lyubomir Rusimov |
| author_facet | Lyubomir Rusimov |
| author_sort | Lyubomir Rusimov |
| collection | DOAJ |
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Objective: To review contemporary concepts regarding the etiology, classifications, and treatment of nonunion following proximal humerus fractures (PHFs). Materials and Methods: For the arrangement of this narrative non-systematic review, an exploratory search in the MEDLINE (via PubMed) database using the keywords “proximal humerus” and“nonunion” for a period covering the last ten years was conducted. The search was performed in November,2024 to include the most recent data available in the literature.Conclusions: Proximal humerus nonunion (PHN) is a relatively rare complication following PHFs. The risk of its occurrence is higher in PHFs with medial cortex insufficiency and fractures initially displaced into varus. Poor reduction and lack of fixation stability due to the surgical technique, along with patient-related factors such as smoking, further increase the risk of developing PHN. Researches on the treatment methods involving open reduction and internal fixation (ORIF) for PHN are heterogeneous, with a limited number of studies and small number of patients, and no method has been established as the gold standard. Regardless of the ORIF method, augmentation with autograft or allograft appears to be mandatory. Compared to ORIF, prosthetic treatment for PHN yields poorer functional outcomes and higher rates of complications and reoperations, regardless of prosthesis type .
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| format | Article |
| id | doaj-art-0d6ef3aabe2b42e3a6791e28109c8cff |
| institution | DOAJ |
| issn | 0473-4378 2815-3715 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Bulgarian Orthopaedics and Trauma Association |
| record_format | Article |
| series | Journal of the Bulgarian Orthopaedics and Trauma Association |
| spelling | doaj-art-0d6ef3aabe2b42e3a6791e28109c8cff2025-08-20T02:48:34ZengBulgarian Orthopaedics and Trauma AssociationJournal of the Bulgarian Orthopaedics and Trauma Association0473-43782815-37152025-04-0162110.58542/jbota.v62i1.160Current concepts in the treatment of proximal humerus nonunions: a reviewLyubomir Rusimov0Second Clinic of Orthopaedics and Traumatology, University Multiprofile Hospital for Active Treatment and Emergency Medicine "N. I. Pirogov", Sofia, Bulgaria Objective: To review contemporary concepts regarding the etiology, classifications, and treatment of nonunion following proximal humerus fractures (PHFs). Materials and Methods: For the arrangement of this narrative non-systematic review, an exploratory search in the MEDLINE (via PubMed) database using the keywords “proximal humerus” and“nonunion” for a period covering the last ten years was conducted. The search was performed in November,2024 to include the most recent data available in the literature.Conclusions: Proximal humerus nonunion (PHN) is a relatively rare complication following PHFs. The risk of its occurrence is higher in PHFs with medial cortex insufficiency and fractures initially displaced into varus. Poor reduction and lack of fixation stability due to the surgical technique, along with patient-related factors such as smoking, further increase the risk of developing PHN. Researches on the treatment methods involving open reduction and internal fixation (ORIF) for PHN are heterogeneous, with a limited number of studies and small number of patients, and no method has been established as the gold standard. Regardless of the ORIF method, augmentation with autograft or allograft appears to be mandatory. Compared to ORIF, prosthetic treatment for PHN yields poorer functional outcomes and higher rates of complications and reoperations, regardless of prosthesis type . https://www.jbota.org/index.php/jbota/article/view/160Key words: proximal humerus fractures, nonunion, locking plate, intramedullary nail, allograft, autograft; |
| spellingShingle | Lyubomir Rusimov Current concepts in the treatment of proximal humerus nonunions: a review Journal of the Bulgarian Orthopaedics and Trauma Association Key words: proximal humerus fractures, nonunion, locking plate, intramedullary nail, allograft, autograft; |
| title | Current concepts in the treatment of proximal humerus nonunions: a review |
| title_full | Current concepts in the treatment of proximal humerus nonunions: a review |
| title_fullStr | Current concepts in the treatment of proximal humerus nonunions: a review |
| title_full_unstemmed | Current concepts in the treatment of proximal humerus nonunions: a review |
| title_short | Current concepts in the treatment of proximal humerus nonunions: a review |
| title_sort | current concepts in the treatment of proximal humerus nonunions a review |
| topic | Key words: proximal humerus fractures, nonunion, locking plate, intramedullary nail, allograft, autograft; |
| url | https://www.jbota.org/index.php/jbota/article/view/160 |
| work_keys_str_mv | AT lyubomirrusimov currentconceptsinthetreatmentofproximalhumerusnonunionsareview |