Index. G Giant cell tumor, 136, 137 Gilchrist dressing, 157 Gyrotonic training, 168, 169

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Cleopatra Carpenter
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1 A Abduction pillow, 157 Active-assistive movement, 164 Activities of daily living (ADL) training, 166 American Shoulder and Elbow Surgeons (ASES), 173 instability, 177 patient self-evaluation, 175 physician assessment, 176 shoulder assessment form, 174 signs, 176 strength, 176 Analgesia, 147, 156, 158, 161 Anatomy acromio-clavicular joint, 9 acromion, 9 axillary nerve (C5, C6), 10 biceps brachii muscle, 10 capsular and ligamental stabilizers, 10 deltoid muscle, 10 gleno-humeral joint, 9 pectoralis minor muscle, 9 subscapularis and teres minor muscle, 10 subscapularis tendon, 9 supra-and infraspinatus muscle, 10 suprascapular nerve (C5 and C6), 10 supraspinatus and infraspinatus muscle s tendons, 9 Angiography, 42, 43, 54, 213, 216 AO Paediatric Classification, 247 Arm sling/bronner sling, 157 Arthroscopy advantages, 123 greater tuberosity fractures avulsion fracture, 124 healing of, 124 minimally invasive techniques, 123 open reduction and internal fixation, 123, 124, prevalence of, 124 speedbridge-technique, suture-bridge technique, 124 implant removal, lesser tuberosity fractures, proximal humerus malunion, management of, 128, 130 rotator cuff repair, 127 Association for Osteosynthesis classification (AO classification), Avascular necrosis (AVN), 39, 40, 42 arthroscopy, 207 and cephalic collapse, 207 complication, 206 conservative therapy, 207 fracture sequelae, 207 humeral head replacement, injury/surgical intervention, 205 partial/total implant removal, resurfacing arthroplasty, 208 retrospective study, 205 sub-classification system, 207 total shoulder replacement, B Body mass index (BMI), Bone mineral density (BMD), 75 age factor, 15 alcohol consumption, 16 conventional plate fixations, 76, 77 conventional radiography, 78 CT, and fracture risk, 15 risk factors, 76 smoking, 16 spherical head screws, 76, 77 C Chondrosarcoma, 133, 139, 140, Computed tomography (CT) axial orientation, 37 Bankart lesions, 36 fracture fragments, 36 humeral head, 35 multidetector CT, 35 multi-part fracture, 37 traumatic injuries, shoulder, 36 Constant Score, 93, 95, 151, 155, , 208, 209 Continuous passive motion (CPM), 164 Cuff disorders. See Rotator cuff tears (RCTs) Springer International Publishing Switzerland 2015 P. Biberthaler et al. (eds.), Fractures of the Proximal Humerus, Strategies in Fracture Treatments, DOI /

2 258 D Deltoid-splitting approach, 102, 105, 123 Deltopectoral approach, 102 anatomical reduction, 123 anterior deltoid function, 104 clavipectoral fascia, 103 comminuted/dislocated fracture types, 103 conjoint tendon, 104 coracoacromial ligament, 103 fracture fragments, devascularization of, 104 Hohmann-retractor, 103, 104 humeral head ischemia, predictors of, secure internal fixation, 123 skin incision, 103, 104 Desault dressing, 157 Disability of the Arm, Shoulder and Hand (DASH), 155, 171, 172, 174 E Elastic stable intramedullary nail (ESIN), Electrotherapy, 160 Ergotherapy, 166 Ewing s sarcoma, 133, 135, Exercise, 79, 83, 92, 93 acute phase, resistance, self-exercise, 170 self-rehabilitation exercises, 94 stability, , trunk stabilization, 162 F Four part fractures, 36, 40, 49, 79 anatomy and exposure, calotte fragment, 114 CT, 114 non-operative management, 89, 90, postoperative care, preoperative evaluation, 115, 116 rehabilitation protocol, surgery, indications for, surgical treatment, in valgus malposition, 114 Fracture dislocation, 14, 25, 127 Codman classification, 53 diagnostics and therapy collateral nerve lesions, 54 CT angiography, 54 endoprosthesis, 57 head-fragment, 55 Hill-Sachs lesion, 55 internal fixation, 55 locking plate osteosynthesis, 58 Mc Laughlin technique, 55 multi-part fracture, 56 osteosynthesis, 55 Resch percutaneous transfixation, 55 supra-spinatus muscle tendon, 55 tuberosity, 55 intrathoracic displacement, 245 trauma mechanisms, 54 Fracture management, children acute complications, classification, growth and development, incidence, 242 mechanism of injury, treatment age and deformity, 247 AO Paediatric Classification, 247 deltopectoral approach and fixation, 253 fixation device, 249 nonoperative treatment, 248 operative intervention, 252 percutaneous pinning technique, 250, 253 reduction technique, 248, 251 remodeling capacity and rationale, 246 titanium elastic intramedullary nailing, 253 G Giant cell tumor, 136, 137 Gilchrist dressing, 157 Gyrotonic training, 168, 169 H Hertel classification, Hohmann-retractor, 103, 104 Humeral head ischemia, I Injury Severity Score (ISS), 63 Intraoperative considerations anterolateral deltoid-splitting approach, 102, 105 deltopectoral approach, 102 anterior deltoid function, 104 clavipectoral fascia, 103 comminuted/dislocated fracture types, 103 conjoint tendon, 104 coracoacromial ligament, 103 fracture fragments, devascularization of, 104 Hohmann-retractor, 103, 104 humeral head ischemia, predictors of, skin incision, 103, 104 patient positioning, pre-operative assessment, 101 surgical equipment/fixation devices, Iontophoresis, 160 J Juvenile bone cyst, 135, K K-wires, 84, 110, 117

3 259 L Locking plate fixation, 129 M Magnetic resonance imaging (MRI), 41, 143, 188, 189, 234, 243, 248 AO classification, 39 avascular necrosis, 39 disadvantages, 37 greater tuberosity (GT), 40 proximal humerus fractures and RC lesions, 39 soft tissue and pathological changes, 39 Malunions, clinical presentation/evaluation laboratory values, 189 physical examination, 188 radiographs, treatment, Manual lymph drainage, 159 Medical training therapy (MTT), Metastases, 135, Modified deltoideo-pectoral approach, 84 Multiple myeloma (MM), Munich Shoulder Questionnaire (MSQ), Muscle function test functional testing, 155 muscle strength, N Neer classification, 48, 187 antero-inferior and posterior dislocation, 49 anteroposterior radiographs, 47 four-part fracture, 49 intraobserver reproducibility and reliability, 47 McLaughlin procedure, 49 tuberosity, 49 two-part fracture, 49 undislocated fractures, 47 Nerve injury, 70, 188 affected nerves, detection and examination, 221 diligent operating skills, 219 injury mechanism, long term outcome, 222 pathomechanism of lesion, 219 therapeutic approach, 219, 220 treatment, 222 types, 219, 220, 221 Neutral zero method, 154 Non-operative management, 83 clinical outcomes, co-morbid conditions, 89 diagnosis, 90, 91 elderly population, 89 initial immobilization, 90, 92 patient-related factors, 89 rehabilitation controlled clinical trials, 90 conventional mobilization regimens, 95 early mobilization regimens, 95 immediate mobilization, 93 immediate physiotherapy, 93 mobilization exercises, 93 non-union or fracture displacement, 95 principal of, 90, 92 prolonged immobilization, 92 regimens, 92 self-rehabilitation exercises, three-and four-part fractures, 89, 90 Non-union fracture, 187, 225, 228 clinical presentation/evaluation laboratory values, 189 physical examination, 188 radiographs, treatment, O Open reduction and internal fixation (ORIF), 53, 113, 206 Orthopedic manipulative therapy (OMT), 166 Osteoporosis BMD, 15, 75 conventional radiography, 78 CT, risk factors, 76 spherical head screws, 76, 77 clinical manifestations, 75 cranial screw cut out, non-union, 77 decision-making, 77 gender, 16 glucocorticoids, 16 hormonal changes, 16 lower trabecular bone density, 75 medical treatment, 4 nutrition, 16 preoperative assessment, local bone quality, 78 preoperative planning, prevalence, 6 risk factor, 15 risks, evaluation of, 78 trauma mechanism, 78 Osteosarcoma, 133, 135, Oxford Score, 155 P Pathologic fracture benign tumors, giant cell tumor, 137 classification, definition, 133 diagnostics, enchondroma, juvenile bone cyst, epidemiology and etiology, 135

4 260 Pathologic fracture (cont.) primary malignant tumors chondrosarcoma, Ewing s sarcoma, metastases, multiple myeloma (MM), osteosarcoma, surgical treatment, Patient-controlled analgesia (PCA), 158 Periprosthetic complications clinical outcome, 225 fracture arthroplasty, 226 glenohumeral function, 228 glenoid fractures, glenoid loosening, hemiarthroplasty, 225 humeral component, intraoperative fractures, 229 malpositioning and glenohumeral instability, meta-analysis, 226 periprosthetic infection, 235 postoperative fractures, 229, 231 reverse shoulder arthroplasty, 225 scapular notching, transverse and short oblique fractures, 228 tuberosities, 231 Wright and Cofield classification, 228 Physical therapy and rehabilitation active movement, transition to, CPM, 164 electrotherapy, 160 ergotherapy, 166 everyday life behavior, 168 exercise acute phase, resistance, stability, , gyrotonic training, 168, 169 inspection, 154 instability, 154 iontophoresis, 160 joint mobilization, structure of, massages manual lymph drainage, 159 scar, 159 traditional, MTT, muscle function test, neurological status, 155 axillary nerve, 156 median nerve, 156 musculocutaneous nerve, 156 radial nerve, 156 OMT, 166 palpation, 154 passive exercising, 163 range of motion neutral zero method, 154 rehabilitation training, 170 shoulder joint, functionality, TENS, 160 therapeutic measures analgesia, 158 cooling applications, 158 heat applications, positioning and splint supply, 157 therapeutic regimens, ultrasound, 160 Plain imaging a-p view, axial view, computed tomography (CT), 32 concomitant injuries, 31 lateral view, 30 multi-fragment fracture, 32 non-dislocated fracture, 32 scapular y-view, 31 trauma series, 30, 31 Velpeau view, 29 x-ray techniques and application, 32 Pressurization-technique, 232 Proprioceptive neuromuscular facilitation (PNF), Proximal humeral fractures amputations, 62 ATLS, 64 in children (see Fracture management, children) and concomitant fractures, 63 diagnostic and therapeutic effort, 64 epidemiology age and gender, 5 6 definition, 3 fracture region, 4 5 incidence rates, 4, 7 medical treatment and social conditions, 6 morbidity and mortality, 3 time of accident, 6 extremity injury, 62 incidence and injury pattern, 62 limitations, 64 location of, 63 longitudinal analysis, 61 mortality rates, 61 nerve injury (see Nerve injury) physical examination dislocation fracture, 25 meticulous neurovascular examination, 25 neuro-vascular lesions, 25 peripheral pulses, 26 thorax, 26 polytrauma, 61 risk factors age facctor, 15 BMI, diabetes mellitus, 14 epilepsy, 14 ethnical differences, 17 falls, gender, 16

5 glucocorticoids, 16 handedness, 14 loss of motion, 13 nutrition, 16 osteoporosis and BMD, therapeutical options, 13 visual impairment/deafness, 15 therapeutic data, 64 therapy and operational procedure, 62 R Reverse shoulder arthroplasty (RSA), 73, 74 Rotator cuff tears (RCTs), 69 arthroscopy clinical data, diagnostics, algorithm for, 72 disadvantage, 72 treatment considerations, CT, 71 etiology of, MRI, 71 plain radiographs, 70 preexisting early cuff arthropathy, 70 preoperative diagnostics, 70 typical fracture dislocation, ultrasonography, 71 S Scapula alata syndrome, 20 Scar massage, 159 Shifting technique, 159 Shoulder joint active stabilisators, anatomy, 9 axial view, plain imaging, cohesion, 22 dynamic mechanisms, functionality, glenoid, 19 glenoidal cavity, 21 humeral head s circumference, 21 indications, 31 kinematics, 20 lower extremity, 19 scapulae muscle and sternocleidomastoideus muscle, 20 shoulder motion, 19 stability, 21, 22 supraspinatus and deltoid muscles, 21 vacuum effect, 22 Shoulder Pain and Disability (SPADI), 155, 172 Speedbridge-technique, Spontaneous fractures, 133 Stiffness clinical findings, definition, pathology, prevalence, 198 treatment arthroscopic capsulotomy, 201 arthroscopy, 201 deltoideo-pectoral approach, 201 extraarticular pathologies, 202 fracture sequelae type 1, 201 immobilisation, 200 operative intervention, 200 ORIF, 201 physiotherapy and self-mobilisation, 202 prophylactic measures, 200 radiofrequency electrical tool, 201 results, risk factor, 200 tuberosities, 200 Surgical decision making non-operative treatment, 83 operative treatment, 84 treatment, timing of, 85 Suture-bridge technique, 124, T Three part fractures anatomy and exposure, greater tuberosity fracture, 109, 113 lesser tuberosity fractures, 109 non-operative management, 89, 90, open management of, 110 percutaneous management of, periosteal conjunction, 114 postoperative care, preoperative evaluation, 115 rehabilitation protocol, surgery, indications for, surgical neck, 109 surgical treatment, Traditional massage, Transcutaneous electrical nerve stimulation (TENS), 160 Transverse friction, 159 Trauma mechanism, 78, 113 TraumaRegister DGU (TR-DGU), 63 Two part fractures greater tuberosity fracture, 109 lesser tuberosity fractures, 109 Neer classification, 49 non-operative management, 95, 96 open management of, 110 patient s functional outcomes, 109 percutaneous management of, U Ultra-highmolecular-weight polyethylene (UHMWPE), 232 Ultrasound (US), 39, 41 42, 73, 160, 221, 243 Upper extremity, 3, 6, 13, 41, 62, 103, 135, 172, accident, 179, 182 damage, 180, 181 GdB tables, 181 household activity,

6 262 Upper extremity (cont.) individual performances, 182 insurance, 181 legal work insurance (GUV), MdE-value, 180 moving deficits, 181 performance exclusion, 181 V Vascular injuries anatomy and pathomechanisms, diagnosis, 213 epidemiology, 211 post-therapeutical management and outcome, treatment active bleedings, 214 amputations, 214 ischemia, 214 patency rates, 215 semi-closed procedure, 215 sternotomy/osteotomy, 214

Index. B Backslap technique depth assessment, 82, 83 diaphysis distal trocar, 82 83

Index. B Backslap technique depth assessment, 82, 83 diaphysis distal trocar, 82 83 Index A Acromial impingement, 75, 76 Aequalis intramedullary locking avascular necrosis, 95 central humeral head, 78, 80 clinical and functional outcomes, 95, 96 design, 77, 79 perioperative complications,