Operative Treatment of Fracture of The Proximal Humerus

Chung, Min Young; Rhi, Won Suck; Chung, Jin Young; Jeun, Soo Young; Lee, Soo Myeong; Song, Won Cheul

Abstract

Recently, the incidence of fracture and dislocation of the proximal humerus has been increased with increment of traffic accident and industrial accident. Although most proximal humeral fractures can be treated satisfactorily by simple conservative treatment, the displaced fracture or fracture-dislocatiion of the proximal humerus demands special treatment and judgement. It has been reported that the results of the surgical treatment of the unstable fracture of the proximal humerus was better than that of conservative treatment. The authors analysed 32 cases displaced fracture or fracture-dislocation of the proximal humerus treated operatively which were followed up more than 1 year at the Dae Han Hospital from June, 1990 to May, 1993. The obtained results were as follows; l. According to Neer's classification, there were 2-part fracture in 3 cases(9%), 3-part in 17 cases(54%), 4-part in 2 cases(6%), fracture-dislocation in 8 cases(25%) and head splitting in 2 cases(6%). 2. The clinical results by Neer's criteria were excellent in 9 cases(28%), good in 14 cases(44%), fair in 7 cases(22%), and poor in 2 cases(6%) among the 32 cases. 3. The complication were limitation of motion in 4 cases, avscular necrosis of humeral head in 2 cases, nonunion in 1 case, delayed union in 1 case, ectopic ossification in 1 case and malunion in 1 case. 4. In the unstable fracture of the proximal humerus treated by accurate reduction and rigid fixation with intensive rehabilitation can be obtained, relatively satisfactory results because of the inability to maintain an acceptable closed reduction.