This open access book offers comprehensive coverage of all relevant aspects of shoulder fractures, also known as fractures of the proximal humerus, with a special focus on existing controversies in their treatment. Throughout the volume the author outlines the development of the modern scientific understanding in the field and the increasing operative approach to these injuries throughout the 20th century.
The volume is subdivided into five sections, the first of which introduces shoulder fractures, their morphology and epidemiology. The second one presents their history, from the earliest known medical text in ancient Egypt to the mid-twentieth century. In the third part, the author discusses the challenges implied in understanding and translating fracture patterns into hierarchies and classification systems. Based on current clinical trials, part four casts new light on the existing tension between an increasing interest in surgical procedures and implants, and the failure of emerging empirical evidence to demonstrate benefits for the vast majority of patients.
In the book’s conclusions, elaborating on this evidence, the author shares his reflections on the changing approaches to shoulder fractures and interprets them within a broader context of intellectual history.
This book appeals to a broad readership, including orthopaedic residents, shoulder surgeons, traumatologists, and other clinical decision-makers, and those with an interest in evidence-based practice and the history and philosophy of medicine.
Part 1: What is a shoulder fracture?.-
1. Shoulder Fractures: A Brief
Guide to Terminology.-
2. The Epidemiology of Shoulder Fractures.-
3. The
Morphology of Shoulder Fractures: An Iconography.- . Part 2: History:
shoulder fractures from ancient Egypt to 1950.-
4. Pre-Radiological
Diagnostics and Classification of Shoulder Fractures.-
5. Interventions for
Shoulder Fractures from Ancient Egypt to the Eighteenth Century.-
6.
Pathoanatomical Conceptions of Shoulder Fractures in the Nineteenth Century.-
7. Radiology and the Advent of Surgical Interventions for Shoulder
Fractures.- . Part 3: Knowing and Telling a Fracture.-
8. Why Do We Classify
Shoulder Fractures?.-
9. Imaging-Based Shoulder Fracture Classification
Systems.-
10. Why Do We Disagree When Classifying Shoulder Fractures?.-
11.
Interventions for Shoulder Fractures: The Evidence-Base.-
12. The Rise and
Fall of an Implant: Locking Plates in Shoulder Fractures.- . Part 4: Eminence
meets Evidence.-
13. The Use of Reverse Shoulder Arthroplasty in Shoulder
Fractures.-
14. Outcome after Shoulder Fractures.-
15. Complications After
Shoulder Fractures.-
16. Bridging the Evidence-Practice Gap in Shoulder
Fracture Management.- . Part 5: Conclusion.- . Shoulder Fractures in Context:
The Academic Bonesetter.
Stig Brorson is a consultant shoulder surgeon and professor in orthopaedics at University of Copenhagen. He has completed studies in philosophy, archaeology and classical civilization. He holds a PhD in medical philosophy and a DMSc in fractures of the proximal humerus. He has published extensively on evidence-based orthopedics, clinical epidemiology, decision theory, history and philosophy of medicine. He is a leading expert in shoulder fractures and has published scholarly papers and book chapters on most aspects of these injuries covering their history, classification, evidence-based practice, decision-making, management and prognosis. Annually, he is responsible for the treatment of about 200 patients with displaced shoulder fractures at a Danish university hospital and he has authored national and international treatment guidelines. For two decades he has conducted clinical trials and summarized clinical evidence on shoulder fractures in systematic reviews andmeta-analyses. He is a sought after medical advisor, teacher, textbook author and supervisor in evidence-based medicine, clinical decision-making and shoulder surgery. He is a proponent of evidence-based orthopaedic practice, patient involvement and clinical ethics. He has questioned the benefits of surgery in certain geriatric upper limb injuries and he is an advocator of de-implementation of low-value surgical interventions.
