A Clinical Study on the Fracture of the Proximal Humerus

Choi, Kyung Soo; Choung, Eu Sub; Yang, Chang Real; Yoo, Byung Hee

Abstract

In recent years, there has been a tendency to advocate operative treatment as the method of choice for certain fractures of the proximal humerus. But the management of this fracture is still under debate, especially in the elderly patients. Seventy eight patients with displaced fractures of the proximal humerus were reviewed, and the results were as follows ; l. Among the 78 patients, the ratio of males and females was 44:34 and the highest incidence was between the ages of 40 and 49 years. 2. The most common cause of injuries was traffic accident (57.7%), and falling or slipped down was in 33.3%. 3. According to the classificatoin of Neer, the commonest type was two part fracture (60.3%). 4. Fifty-three cases were treated conservatively, and surgical treatment was done at 25 cases. At old age, or patients with severe associated injury, external fixation was done (12 cases), and one case of four-part fracture was treated by prosthetic replacement. 5. The results were analyzed according to Neer's criteria, and 38 cases (48.7%) showed good, 25 cases (32.1%) was fair, and 15 cases (19.2%) was poor. 6. Total cases with complication were 19 (24.4%), and joint stiffness was most common (10 cases). 7. At elderly patient above 50 years old, the result of surgical treatment was satisfactory in 72.7%, and 58.8% was so when treated conservatively. And the external fixation showed slightly better result than that of internal fixation.