Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Nov 1998
The clinical relevance of posttraumatic avascular necrosis of the humeral head.
Twenty-five patients with a partial or complete collapse of the humeral head caused by post-traumatic avascular necrosis underwent clinical and radiologic evaluation at an average of 7.5 years (range 2.3 to 17.6 years) after having an underlying proximal humeral fracture. Posttraumatic humeral head necrosis was always associated with disability. The overall shoulder function as assessed with the Constant score was 46 points, corresponding to a functional shoulder value of 51% of an age- and sex-matched normal control group. ⋯ The results obtained in group 1 were comparable to those reported after hemiarthroplasty for complex humeral fractures. A proximal humeral fracture that is at risk for avascular necrosis has to be reduced anatomically if joint-preserving treatment is selected. If anatomic reduction cannot be obtained, other treatment options such as arthroplasty should be considered.