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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 5/2005

01-06-2005 | Original Article

Fractures in the proximal humerus: functional outcome and evaluation of 70 patients treated in hospital

Authors: Tore Fjalestad, Knut Strømsøe, Judith Blücher, Bjørn Tennøe

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2005

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Abstract

Introduction

Patients with proximal humeral fractures are mostly elderly. In addition to the proximal humeral fracture, they often have other injuries related to poor bone quality. The surgical treatment of proximal humeral fractures in elderly patients with comminuted fractures is associated with several problems and a high frequency of complications. The aims of this study were to evaluate patients with a proximal humeral fracture treated in a hospital, assess the outcome of the fracture treatment, and decide whether surgical treatment of displaced proximal humeral fractures is superior to conservative treatment or not.

Materials and methods

Patients with fractures of the proximal part of the humerus treated in our hospital were followed during two different periods (14 and 10 months). The study in the first time period was retrospective in design, while in the second period the patients were followed prospectively. Seventy patients, (71% women) with a mean age of 71 years, were included in the study. A functional test was performed within 12–14 months after the injury using a modified Rowe shoulder score. Surgical treatment was performed in 15 patients (21%). Neither the surgical approach nor the implants used for osteosynthesis were standardized. Fifty-five patients (79%) were treated conservatively with a modified Velpeau bandage or a sling.

Results

The fractures were classified according to AO into type A (27%), type B (58%) and type C (14%). Osteoporotic risk factors were present in many of the patients, mainly characterized by other skeletal injuries than the proximal humeral fracture (43%). In the group of complex, displaced, non-impacted fractures B2, B3, C2, C3 included (20 fractures), the group treated conservatively had a mean Rowe score of 48/75 (64% of maximum score) and SD 16.8, while in the surgically treated group the mean score was 28/75 (38% of maximum score) and SD 8.1. The difference between the two treatments was significant, with a p-value of 0.01 in favour of the conservatively treated group.

Conclusion

The number of patients in each of the fracture groups was low, but surgery did not benefit the patients with complex, displaced fractures in this study.
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Metadata
Title
Fractures in the proximal humerus: functional outcome and evaluation of 70 patients treated in hospital
Authors
Tore Fjalestad
Knut Strømsøe
Judith Blücher
Bjørn Tennøe
Publication date
01-06-2005
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 5/2005
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-005-0803-9

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