NONOPERATIVE TREATMENT OF COMMINUTED FRACTURES OF THE PROXIMAL HUMERUS IN ELDERLY PATIENTS

The purpose of this retrospective study was to assess the clinical and radiographical results of non-operative treatment of displaced multif ragmental fractures of the proximal humerus with a minimum follow-up o f 10 years. Fifteen patients (one man, 14 women) with 17 injured shoul ders were examined. The Neer classification system was used to classif y the fractures, and the functional outcome was assessed using the Con stant score. At the 10 year review, the mean Constant score for the pa tients in the three-part fracture group was 59, and 47 in the four-par t fracture group. The range of motion was satisfactory with a mean fle xion and abduction over 90 degrees. Only four patients reported pain a nd it was graded as mild. In spite of low functional scoring and pool fracture reduction in many shoulders, the patient's contentment with t heir injured shoulder after. 10 years with high. Radiographical examin ation revealed severe osteoarthrosis in one shoulder, and humeral head osteonecrosis in two shoulders. Results from this study suggests that non-operative treatment of displaced three-part fractures of the prox imal humerus should be considered. (C) 1998 Elsevier Science Ltd. All lights reserved.