Incidence and risk factors for pseudosubluxation of the humeral head following proximal humerus fracture

© 2022 The Authors.

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 6(2022), 3 vom: 10. Mai, Seite 338-342
1. Verfasser: Cirino, Carl M (VerfasserIn)
Weitere Verfasser: Kantrowitz, David E, Cautela, Frank S, Gao, Michael, Cagle, Paul J, Parsons, Bradford O
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2022
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Axillary nerve Deltoid atony Humeral head inferior subluxation Neuropraxia Proximal humerus fracture Shoulder Trauma
LEADER 01000caa a22002652c 4500
001 NLM340953225
003 DE-627
005 20250303085414.0
007 cr uuu---uuuuu
008 231226s2022 xx |||||o 00| ||eng c
024 7 |a 10.1016/j.jseint.2022.01.013  |2 doi 
028 5 2 |a pubmed25n1136.xml 
035 |a (DE-627)NLM340953225 
035 |a (NLM)35572447 
040 |a DE-627  |b ger  |c DE-627  |e rakwb 
041 |a eng 
100 1 |a Cirino, Carl M  |e verfasserin  |4 aut 
245 1 0 |a Incidence and risk factors for pseudosubluxation of the humeral head following proximal humerus fracture 
264 1 |c 2022 
336 |a Text  |b txt  |2 rdacontent 
337 |a ƒaComputermedien  |b c  |2 rdamedia 
338 |a ƒa Online-Ressource  |b cr  |2 rdacarrier 
500 |a Date Revised 16.07.2022 
500 |a published: Electronic-eCollection 
500 |a Citation Status PubMed-not-MEDLINE 
520 |a © 2022 The Authors. 
520 |a Background: Humeral head pseudosubluxation (HHPS) in relation to the glenohumeral joint is a common finding following fractures of the proximal humerus. The temporary inferior subluxation of the humeral head may be secondary to a transient axillary nerve neuropraxia, pain inhibition of the deltoid, or hemarthrosis or capsular disruption that alters the physiologically negative pressure in the glenohumeral joint. Despite the frequency of this finding, it is not well described in the literature. This study sought to describe the incidence, risk factors, and rate of resolution of HHPS following proximal humerus fracture 
520 |a Methods: The practice of two fellowship-trained shoulder and elbow surgeons was queried for proximal humerus fractures. Patient radiographs were reviewed at the time of injury and all subsequent follow-ups through one year after injury. Data collection included the presence of HHPS, type of fracture based on the Neer classification, operative vs. nonoperative management, and resolution of HHPS. Exclusion criteria included skeletally immature patients, fracture-dislocations, patients treated with reverse shoulder arthroplasty, inadequate follow-up, or those patients with incorrect International Classification of Diseases coding 
520 |a Results: The incidence of HHPS was 20.0% (103 out of 515 patients) overall. Patients who required surgical intervention were more likely to develop pseudosubluxation than those who were treated conservatively (P < .001). There was an increasing incidence of pseudosubluxation based on the Neer classification, with 0-part fractures demonstrating a 2.56% (2/78) rate, whereas 4-part fractures were found to have HHPS in 35.1% (20/57) of cases (P < .001). All patients were found to have resolution of their HHPS at the final follow-up or one year after injury. None of age, sex, obesity, or injury to the dominant arm was associated with the occurrence of HHPS. There was, however, a statistically significant difference in the body mass index of those who developed HHPS (28.4, ± 5.77) vs. those who did not (26.2, ± 5.32, P < .01) 
520 |a Conclusion: This retrospective radiographic study is the largest to date investigating the incidence of HHPS following proximal humerus fracture and first to correlate with Neer classification and operative intervention. We found that HHPS occurs in one-fifth of acute proximal humerus fractures and resolves regardless of intervention. More complex fractures, including those with increasing Neer parts or requiring operative intervention, developed HHPS at higher rates than simpler fracture patterns. This study will help both general orthopedists as well as shoulder surgeons understand the epidemiology of HHPS and provide reassurance to patients that PS is a benign finding with expected spontaneous resolution by one year 
650 4 |a Journal Article 
650 4 |a Axillary nerve 
650 4 |a Deltoid atony 
650 4 |a Humeral head inferior subluxation 
650 4 |a Neuropraxia 
650 4 |a Proximal humerus fracture 
650 4 |a Shoulder 
650 4 |a Trauma 
700 1 |a Kantrowitz, David E  |e verfasserin  |4 aut 
700 1 |a Cautela, Frank S  |e verfasserin  |4 aut 
700 1 |a Gao, Michael  |e verfasserin  |4 aut 
700 1 |a Cagle, Paul J  |e verfasserin  |4 aut 
700 1 |a Parsons, Bradford O  |e verfasserin  |4 aut 
773 0 8 |i Enthalten in  |t JSES international  |d 2020  |g 6(2022), 3 vom: 10. Mai, Seite 338-342  |w (DE-627)NLM307818438  |x 2666-6383  |7 nnas 
773 1 8 |g volume:6  |g year:2022  |g number:3  |g day:10  |g month:05  |g pages:338-342 
856 4 0 |u http://dx.doi.org/10.1016/j.jseint.2022.01.013  |3 Volltext 
912 |a GBV_USEFLAG_A 
912 |a SYSFLAG_A 
912 |a GBV_NLM 
912 |a GBV_ILN_50 
912 |a GBV_ILN_65 
912 |a GBV_ILN_350 
951 |a AR 
952 |d 6  |j 2022  |e 3  |b 10  |c 05  |h 338-342