How to treat stiffness after proximal humeral fractures?
Publisher DOI
PubMed ID
37526247
Abstract
Shoulder stiffness is a frequent complication after proximal humeral fractures treated with or without surgery. Shoulder stiffness is associated with high rates of absence from work and a significant financial burden for the healthcare system. Secondary stiffness is characterized by additional extracapsular adhesions, including subacromial, subcoracoid, and subdeltoid spaces, usually derived from post-fracture or post-surgical extraarticular hematomas. Several secondary causes may coexist with capsular and extracapsular adhesions decreasing the shoulder motion, such as malunion, nonunion, metalwork failure, infection, and osteoarthritis, among others. Conservative treatment, usually prescribed for primary shoulder stiffness, has shown unfavorable results in secondary stiffness, and surgical intervention may be required. Surgical interventions need to be patient-specific. Usually, open or arthroscopic fibro-arthrolysis and subacromial release are performed, together with plate removal and biceps tenotomy/tenodesis. In severe osteoarthritis, shoulder replacement may be indicated. Ruling out infection is recommended in every case.
Date Issued
2023-08-01
Publication Type
Article
Subject(s)
Subjects
PROMs arthrofibrosis proxima humeral fracture shoulder stiffness
Language(s)
en
Author(s)
Rojas, J Tomás | |
Rashid, Mustafa S |
Additional Credits
Journal
EFORT open reviews
Publisher
The British Editorial Society of Bone & Joint Surgery
ISSN
2058-5241
Access(Rights)
open.access