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    Three-part head-splitting proximal humerus fracture through a unicameral bone cyst

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    Authors
    Younghein, John A.
    Eskander, Mark S.
    DeAngelis, Nicola A.
    Wixted, John J.
    UMass Chan Affiliations
    Department of Orthopedic Surgery
    Department of Orthopedics and Physical Rehabilitation
    Document Type
    Journal Article
    Publication Date
    2012-06-01
    Keywords
    Adult
    Bone Cysts
    Combined Modality Therapy
    Female
    Fracture Fixation, Internal
    Humans
    Multiple Trauma
    Osteotomy
    Shoulder Fractures
    Treatment Outcome
    Orthopedics
    Rehabilitation and Therapy
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    Link to Full Text
    http://dx.doi.org/10.3928/01477447-20120525-50
    Abstract
    Unicameral bone cysts are rare in adults and are most often found incidentally on radiographs. However, they can persist from the adolescent period and may be present in locations that predispose to or exacerbate fractures.This article describes a case of a healthy 40-year-old woman who sustained a proximal humerus trauma that involved a large unicameral bone cyst, resulting in a 3-part head-splitting fracture. The epiphyseal location of the cyst contributed to the severity and extent of the fracture that resulted from a simple fall. Given the age of the patient, open reduction and internal fixation with a locking plate and lag screws was performed. The patient chose open reduction and internal fixation to preserve a hemiarthroplasty procedure in case of future revision. Successful humeral head reconstruction was achieved, and the patient fully recovered. One year postoperatively, the patient underwent arthroscopic debridement to alleviate subjective stiffness and decreased range of motion.Multipart head-splitting fractures require complex repair strategies. The gold standard for the treatment of these injuries is hemiarthroplasty. However, the decision process is difficult in a young patient given the average survival of autoplastic prostheses and the added difficulty of later revision. The current case demonstrates the complexity of decision making resulting from a rare injury in a young, healthy patient and shows that open reduction and internal fixation can provide acceptable reconstruction in such situations.
    Source
    Orthopedics. 2012 Jun;35(6):e988-90. doi: 10.3928/01477447-20120525-50. Link to article on publisher's site
    DOI
    10.3928/01477447-20120525-50
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/42931
    PubMed ID
    22691682
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.3928/01477447-20120525-50
    Scopus Count
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    UMass Chan Faculty and Researcher Publications
    Orthopedics and Physical Rehabilitation Publications

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