A Clinical Study of the Proximal Humeral Fractures

Kim, Chang Soo; Kwon, Chil Soo; Seo, Kwang Yoon

Abstract

Most fractures of the proximal humerus are managed well to simple conservative treatment. But open reduction and interhal fixation of the fragment is definitely indicated in certain types of displaced fractures. Thirty eight cases of fractures of the proximal humerus which were treated at Inje Medical College from January 1980 to December 1985 were analyzed both clinically and radiologically accordingto Neer's classification and the following results were obtained. l. Among the 38 patients, the ratio of male and female was 2.2:1 and the highest incidence was in the fifth decades. 2. The main cause of fracture was traffic accident, 20 cases (52. 6%) and the the next one was falling from a height. 3. According to the classification of Neer, one part acture(52.6%) was the most common type. 4. The common associated injuries were fracture of the lower extremities and forearms. 5. Thirty two cases(84.2%) were treated by conservative treatment and six cases by operative treatment. 6. Thirty eight cases were followed form 6 months to 5 years and 6 months, average 14.3 months, and the results were analyzed according to Neers criteria and 26 cases (68. 6%) showed excellent results. 7. Two cases of limitation of shoulder motion were observed as a complication and one cases of paralysis of deltoid muscle by axillary nerve injury was observed. Excellent functional result could be obtained by a simple external support with early motion in a minimal displacement of proximal humeral fracture. Satisfactory functional result could be obtained by a open reduction and internal fixation with early motion in a severely displaced fracture. But long term immobilization of shoulder could have a poor functional result.