[Fracture sequelae-when, how, what?]

Abstract

The treatment of fracture sequelae following proximal humeral fractures presents a significant challenge, as they range from necrosis and pseudarthrosis to malunions. Classifications such as Boileau's facilitate diagnosis and treatment planning. Type 1 sequelae, characterized by necrosis, can be treated with either anatomical or reverse prostheses depending on the condition of the rotator cuff. Type 2 sequelae involve locked dislocations and may require bony reconstructions. Type 3 pseudarthrosis is managed either with joint-preserving techniques or prosthetic replacement, depending on the degree of degenerative changes. Type 4 malunions often benefit from corrective osteotomies and/or prosthesis implantation. Studies have demonstrated significant functional improvements following surgical intervention, with individual factors such as deformities or rotator cuff condition influencing treatment strategies.