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Surgical Treatment Of The Upper Humerus Fracture

Article written by: ANDREI BOGDAN, MD, Orthopedics-traumatology doctor

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For all traumatic or chronic diseases of the musculoskeletal system, the Centrokinetic private clinic in Bucharest is prepared with an integrated Orthopedic Department, which offers all the necessary services to the patient, from diagnosis to complete recovery.

The Department of Orthopedic Surgery of Centrokinetic is dedicated to providing excellent patient care and exceptional education for young physicians in the fields of orthopedic surgery and musculoskeletal medicine.

Centrokinetic attaches great importance to the entire medical act: investigations necessary for correct diagnosis (ultrasound, MRI), surgery, and postoperative recovery.

Discover the open MRI imaging center in our clinic. Centrokinetic has a state-of-the-art MRI machine, dedicated to musculoskeletal conditions, in the upper and lower limbs. The MRI machine is open so that people suffering from claustrophobia can do this investigation. The examination duration is, on average, 20 minutes.

A clavicle fracture is one of the most common fractures found in orthopedic practice. Most often, it results from a direct fall on the side of the shoulder or a direct blow to the shoulder (85%). The most common causes up to the age of 30 are road accidents and sports accidents (falling from a bicycle).

In epidemiological studies, clavicle fracture accounts for up to 5% of all fractures and up to 44% of scapular girdle fractures. The incidence was estimated to be between 29-64 cases / 100,000 inhabitants/year. It is also characterized by a two-age distribution with peaks under 40 years and over 70 years.

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The fracture of the middle third of the clavicle is the most common clavicle fracture (69-81%). 48-73% of these fractures are displaced fractures. The second most common is a lateral fracture or distal third of the clavicle, accounting for 16-30% of all clavicle fractures, and of these, 10-52% are displaced fractures. Less than 3% are medial or proximal third clavicle fractures. The external or distal 1/3 fracture of the clavicle has an absolute surgical indication.

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Surgical technique

The patient is placed in a supine position (on the back), in a semi-sitting position (beach chair position), and under general anesthesia, an incision of about 5-7 cm is made starting from the middle third of the clavicle, up to the acromio-clavicular joint. A thorough dissection of the subcutaneous tissue is performed and the clavicle with the fracture focus, the deltoid muscles, the trapezius, the pectoralis major, and the coracoid process are highlighted.

Depending on the characteristics of the fracture (single/comminuted fracture, with/without displacement, open/closed fracture, with the involvement of the articular surface / without), it is fixed with a premulated titanium plate and screws, to which an additional implant can be added (AC tight rope) for over-stabilizing the fixation.

Post surgery

After the intervention, the patient remains hospitalized for 1-2 days. He will receive pain medication and antibiotics during his hospitalization. The operated limb is partially immobilized in a Dessault bandage for a few days.

After the surgery, you will be discharged, with the indications related to the recovery and the subsequent controls. Passive early mobilization of the shoulder joint is necessary for the patient to regain normal mobility. Our medical team guides the patient to physical therapy and physiotherapy under the guidance of a doctor.

The patient must understand that after the surgery he has certain limitations in mobility, ie he is forbidden to make certain movements.

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At home

Although recovery from arthroscopy is much faster than a classic operation, it will still take a few weeks for you to fully recover your shoulder joint. You should expect pain and discomfort for at least a week postoperatively. Ice will reduce pain and inflammation.

You must be careful not to sleep on the operated shoulder in the first weeks because the pain and discomfort can worsen. You can take a bath, but without wetting the bandage and incisions. The threads are suppressed at 14 days postoperatively. Physical therapy plays a very important role in the rehabilitation program, and the exercises must be supervized by a physical therapist until the end of the recovery period.

It is very important to follow the recovery program strictly and seriously for the surgery to be a success. Our medical team works on average with the patient after this intervention, 12-18 weeks until the complete recovery of the shoulder.

Following any surgery, medical recovery plays an essential role in the social, professional, and family reintegration of the patient. Because we pursue the optimal outcome for each patient entering the clinic, recovery medicine from Centrokinetic is based on a team of experienced physicians and physical therapists and standardized medical protocols.


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