J Korean Fract Soc.  2011 Jan;24(1):96-99. 10.12671/jkfs.2011.24.1.96.

Conservative Treatment of Valgus Impacted Four-Part Fracture of the Proximal Humerus: A Case Report

• Kim MC
• Cho JL
• Chung HT
• Kim DJ
• Kim IB

• KMID: 1449425
• DOI: http://doi.org/10.12671/jkfs.2011.24.1.96

Abstract

For valgus impacted four part fracture of the proximal humerus, surgical stabilization and early mobilization of the joint can produce the best clinical outcomes. But, we have experienced a case of conservative treatment and gained good clinical results. We have reported this case and included a review of the relevant literatures.

Keyword

Valgus impacted four part fracture; Proximal humerus fracture; Conservative treatment

MeSH Terms

Early Ambulation
Humerus
Joints

Figure

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  Fig. 1 (A) Initial shoulder AP radiograph, (B) shoulder outlet view & (C, D) three Dimensional CT of a 55-year-old-female patient show valgus impacted four part fracture of the proximal humerus.

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  Fig. 2 (A) Final radiographs & (B) three Dimensional CT taken after 10 months show malunion of proximal humerus fracture.

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  Fig. 3 At 10 months follow up, photographs show nearly full range of motion of right shoulder.

Reference

1. Brooks CH, Revell WJ, Heatley FW. Vascularity of the humeral head after proximal humeral fractures. An anatomical cadaver study. J Bone Joint Surg Br. 1993. 75:132–136.

2. Harvie P, El-Guindi M. Four-part valgus impacted proximal humeral fracture presenting three months after injury in a young patient: open reduction and internal fixation with triple osteotomy and bone graft augmentation. J Shoulder Elbow Surg. 2009. 18:e4–e8.

3. Iannotti JP, Ramsey ML, Williams GR, Warner JJ. Nonprosthetic management of proximal humerus fractures. Instr Course Lect. 2004. 53:403–416.

4. Jakob RP, Kristiansen T, Mayo K, Ganz R, Muller ME. Bateman JE, Welsh RP, editors. Classification and aspects of treatment of fractures of the proximal humerus. Surgery of the shoulder. 1984. 1st ed. St Louis: Mosby;330–343.

5. Jakob RP, Miniaci A, Anson PS, Jaberg H, Osterwalder A, Ganz R. Four-part valgus impacted fractures of the proximal humerus. J Bone Joint Surg Br. 1991. 73:295–298.

6. Magovern B, Ramsey ML. Percutaneous fixation of proximal humerus fractures. Orthop Clin North Am. 2008. 39:405–416.

7. Resch H, Beck E, Bayley I. Reconstruction of the valgus-impacted humeral head fracture. J Shoulder Elbow Surg. 1995. 4:73–80.

8. Resch H, Povacz P, Fröhlich R, Wambacher M. Percutaneous fixation of three- and four-part fractures of the proximal humerus. J Bone Joint Surg Br. 1997. 79:295–300.

9. Robinson CM, Page RS. Severely impacted valgus proximal humeral fractures. Results of operative treatment. J Bone Joint Surg Am. 2003. 85:1647–1655.

10. Sanchez-Sotelo J. Proximal humerus fractures. Clin Anat. 2006. 19:588–598.