FUNCTIONAL OUTCOME AFTER MINIMALLY DISPLACED FRACTURES OF THE PROXIMAL PART OF THE HUMERUS

One hundred and four patients who had a minimally displaced fracture o f the proximal part of the humerus (a so-called one-part fracture) wer e managed with a standardized therapy regimen and followed for more th an one year, The clinical outcome was assessed on the basis of pain, f unction, and the range of motion of the shoulder, The duration of foll ow-up averaged forty-one months (range, twelve to 117 months), All fra ctures united without additional displacement, Eighty patients (77 per cent) had a good or excellent result, fourteen (13 per cent) had a fa ir result, and ten (10 per cent) had a poor result, Ninety-four patien ts (90 per cent) had either no or mild pain in the shoulder, eight (8 per cent) had moderate pain, and two (2 per cent) had severe pain, Fun ctional recovery averaged 94 per cent; forty-eight patients (46 per ce nt) had 100 per cent functional recovery, At the time of the most rece nt follow-up, Forward elevation of the injured shoulder averaged 89 pe r cent; external rotation, 87 per cent; and internal rotation, 88 per cent that of the uninjured shoulder, The percentage of good and excell ent results was significantly greater (p < 0.01) and external rotation was significantly better (p < 0.01) at the time of the latest follow- up for the patients who had started supervised physical therapy less t han fourteen days after the injury than for the patients who had start ed such therapy at fourteen days or later.