Three- and four-part fractures have poorer function than one-part proximal humerus fractures
| Autor: | Joseph D. Zuckerman, Christopher Bechtel, Crispin C Ong, Michael Walsh, Kenneth A. Egol |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Proximal humerus Sports medicine Locking plate Fixation (surgical) Fracture Fixation Internal Postoperative Complications medicine Health Status Indicators Humans Orthopedics and Sports Medicine In patient Range of Motion Articular Aged Retrospective Studies Aged 80 and over business.industry General Medicine Recovery of Function Middle Aged Symposium: Fractures of the Shoulder Girdle Surgery Radiography Treatment Outcome Orthopedic surgery Shoulder Fractures Female business Bone Plates |
| Zdroj: | Clinical orthopaedics and related research. 469(12) |
| ISSN: | 1528-1132 |
| Popis: | Locking plates have become a commonly used fixation device in the operative treatment of three- and four-part proximal humerus fractures. Examining function in patients treated nonoperatively and operatively should help determine whether and when surgery is appropriate in these difficult-to-treat fractures.We compared functional scores, ROM, and radiographs in patients with one-part proximal humerus fractures treated nonoperatively to those in patients with displaced three- and four-part proximal humerus fractures treated with open reduction and internal fixation using locking plates.We retrospectively reviewed 142 patients with proximal humerus fractures treated with a standardized treatment algorithm over a 6-year period. Three- and four-part fractures were treated surgically while one-part fractures were treated nonoperatively. Functional scores, ROM, and radiographs were used to evaluate outcomes. American Shoulder and Elbow Surgeons and SF-36 scores were obtained at 12 months. Of the 142 patients, 101 (51 with three- or four-part fractures and 50 with one-part fractures) had a minimum followup of 12 months (average, 19 months; range, 12-64 months).The fractures united in all patients. At 1 year, the patients with one-part fractures had better SF-36 physical and mental scores and American Shoulder and Elbow Surgeons scores than the three- and four-part fractures. Both groups had similar shoulder ROM. Nine patients treated operatively had complications, four of which were related to screw penetration into the joint.Patients with three- and four-part fractures should be advised of the likelihood of persistent functional impairment and a relatively higher risk of complications when treated operatively with locked plates.Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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