Comparative study between operative and conservative treatment in 3 part and 4 part fracture of the proximal humerus

Choi, Chang Hyuk; Kwun, Kwoing Woo; Kim, Shin Kun; Lee, Sang Wook; Shin, Dong Kyu; Park, Bum Jin

Abstract

PURPOSE : Majority of 3-part and 4-part fracture of proximal humerus had been treated by surgical methods. However, Surgical treatment might be inappropriate due to the medical status or combined injures if the patients. Therefore, we compared the operative treatment with the conservative treatment in 3-part and 4-part fracture of proximal humerus.
MATERIALS AND METHODS
: Among the 39 cases of 3-part(30) and 4-part(9) fracture of proximal humerus, 22 cases(57%) were treated by conservative
methods
and 17 cases(43%) were treated by operative methods with T-plate, wire, arthroplasty and screw.
RESULTS
: Among 30 cases of 3-part fracture of proximal humerus, according to the Neer's functional criteria, 12cases(60%) had excellent or satisfactory result in conservative treatment and 7cases(70%) had excellent or satisfactory result in operative treatment. In 9 cases of 4-part fracture of proximal humerus, 2 cases(100%) had poor result in conservative treatment, and 5 cases(71%)had excellent or satisfactory result in operative treatment.
CONCLUSION
: There was no difference in functional result according to the treatment modality in 2-part fracture(p>0.05). but in 4-part fracture, we prefer to treat by operative methods due to avascular necrosis at humeral head and poor functional result with conservative treatment.