ASES/OTA Survey on Classification, Approach and Treatment for Proximal Humerus Fractures

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* 1. What is your society affiliation?

Orthopaedic Trauma Association (OTA) member

American Shoulder and Elbow Surgeons (ASES) member

Member of both the OTA and ASES

Member of neither the OTA nor the ASES

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* 2. What is your gender?

Male

Female

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* 3. How many years have you been in practice?

0-5

6-10

11-15

16-20

>20

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* 4. What is your fellowship training experience?

No fellowship

Fellowship trained in Shoulder and Elbow Surgery

Fellowship trained in Hand and Upper Extremity Surgery

Fellowship trained in Orthopaedic Trauma

Fellowship trained in Orthopaedic Sports Medicine

Other Fellowship or Multiple Fellowships (please specify)

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* 5. What is the geographic location of your practice?

Northeastern United States

Southeastern United States

Midwestern United States

Southwestern United States

Western United States

Canada

International

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* 6. How many proximal humerus fractures do you treat in an average year?

Less than 10

10-25

26-50

50-75

> 75

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* 7. In general, with regard to proximal humerus fracture fixation, what is your preferred surgical approach for the majority of cases?

Anterior (Deltopectoral) Approach

Anterolateral Acromial (Deltoid-Splitting) Approach

Percutaneous

No preference

Other (please specify)

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* 8. In general, with regard to proximal humerus fracture fixation, what is your preferred patient position for the majority of cases?

Supine

Beach Chair

Supine with Bump/"sloppy lateral"

Semi-Sitting

No preference

Other (please specify)

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* 9. When evaluating a patient with an acute proximal humerus fracture, how often do you obtain a pre-operative CT scan?

Never

1-25% of Cases

26-50% of Cases

51-75% of Cases

76-99% of Cases

Always

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* 10. When evaluating a patient with an acute proximal humerus fracture, how often do you obtain a pre-operative MRI?

Never

1-25% of Cases

26-50% of Cases

51-75% of Cases

76-99% of Cases

Always

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* 11. CASE 1:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

Minimally displaced/1-Part

2-Part

3-Part

4-Part

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* 12. CASE 1:

Above are the CT scan images for Case 1. This fracture occurred in a healthy, active 61 year old female after a mechanical fall. She has no significant medical comorbidities. Barring any unforeseen intraoperative findings or complications, what would be your preferred initial treatment be for this fracture?

Nonoperative Treatment

Open reduction internal fixation (ORIF) alone

ORIF with fibular strut graft augmentation

Hemiarthroplasty

Reverse Total Shoulder Arthroplasty

Percutaneous Pinning

Intramedullary Fixation

Other (please specify)

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* 13. CASE 2:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

Minimally displaced/1-Part

2-Part

3-Part

4-Part

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* 14. CASE 2:

Above are the CT scan images for Case 2. This fracture occurred in a 67 year old female after a mechanical fall. She is a former smoker and has Vitamin D deficiency but is otherwise healthy and active. Barring any unforeseen intraoperative findings or complications, what would be your preferred initial treatment be for this fracture?

Nonoperative Treatment

Open reduction internal fixation (ORIF) alone

ORIF with fibular strut graft augmentation

Hemiarthroplasty

Reverse Total Shoulder Arthroplasty

Percutaneous Pinning

Intramedullary Fixation

Other (please specify)

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* 15. CASE 3:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

Minimally displaced/1-Part

2-Part

3-Part

4-Part

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* 16. CASE 3:

Above are the CT scan images for Case 3. This fracture occurred in a 74 year old female after a mechanical fall. Her past medical history is significant for hyperlipidemia and hypothyroidism. Barring any unforeseen intraoperative findings or complications, what would be your preferred initial treatment be for this fracture?

Nonoperative Treatment

Open reduction internal fixation (ORIF) alone

ORIF with fibular strut graft augmentation

Hemiarthroplasty

Reverse Total Shoulder Arthroplasty

Percutaneous Pinning

Intramedullary Fixation

Other (please specify)

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* 17. CASE 4:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

Minimally displaced/1-Part

2-Part

3-Part

4-Part

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* 18. CASE 4:

Above are the CT scan images for Case 4. This fracture occurred in a 79 year old female after a mechanical fall. Her past medical history is significant for breast cancer and hypothyroidism. Barring any unforeseen intraoperative findings or complications, what would be your preferred initial treatment be for this fracture?

Nonoperative Treatment

Open reduction internal fixation (ORIF) alone

ORIF with fibular strut graft augmentation

Hemiarthroplasty

Reverse Total Shoulder Arthroplasty

Percutaneous Pinning

Intramedullary Fixation

Other (please specify)

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* 19. CASE 5:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

Minimally displaced/1-Part

2-Part

3-Part

4-Part

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* 20. CASE 5:

Above are the CT scan images for Case 5. This fracture occurred in a 64 year old female after a mechanical fall. She is otherwise healthy and active. Barring any unforeseen intraoperative findings or complications, what would be your preferred initial treatment be for this fracture?

Nonoperative Treatment

Open reduction internal fixation (ORIF) alone

ORIF with fibular strut graft augmentation

Hemiarthroplasty

Reverse Total Shoulder Arthroplasty

Percutaneous Pinning

Intramedullary Fixation

Other (please specify)

ASES/OTA Survey on Classification, Approach and Treatment for Proximal Humerus Fractures

Question Title

* 1. What is your society affiliation?

Question Title

* 2. What is your gender?

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* 3. How many years have you been in practice?

Question Title

* 4. What is your fellowship training experience?

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* 5. What is the geographic location of your practice?

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* 6. How many proximal humerus fractures do you treat in an average year?

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* 7. In general, with regard to proximal humerus fracture fixation, what is your preferred surgical approach for the majority of cases?

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* 8. In general, with regard to proximal humerus fracture fixation, what is your preferred patient position for the majority of cases?

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* 9. When evaluating a patient with an acute proximal humerus fracture, how often do you obtain a pre-operative CT scan?

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* 10. When evaluating a patient with an acute proximal humerus fracture, how often do you obtain a pre-operative MRI?

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* 11. CASE 1:Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

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* 13. CASE 2: Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

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* 15. CASE 3: Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

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* 17. CASE 4: Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

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* 19. CASE 5: Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

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* 20. CASE 5: Above are the CT scan images for Case 5. This fracture occurred in a 64 year old female after a mechanical fall. She is otherwise healthy and active. Barring any unforeseen intraoperative findings or complications, what would be your preferred initial treatment be for this fracture?

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* 21. Any additional comments?

* 11. CASE 1:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

* 13. CASE 2:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

* 15. CASE 3:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

* 17. CASE 4:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

* 19. CASE 5:

Based on the Neer Classification for proximal humerus fractures, how would you classify this fracture?

* 20. CASE 5:

Above are the CT scan images for Case 5. This fracture occurred in a 64 year old female after a mechanical fall. She is otherwise healthy and active. Barring any unforeseen intraoperative findings or complications, what would be your preferred initial treatment be for this fracture?