Most proximal humeral fractures are well managed with nonoperative treatment and early motion. Displaced fractures of a high-energy injury pose the greatest challenges to successful treatment and functional recovery.
The purpose of this study is to analyze the results of closed and open reduction of displaced proximal humeral fractures according to Neer's classification.
Thirty eight cases of proximal humeral fractures and fracture dislocations were reviewed from March 1990 to may 1992, and the following results were obtained.
1. Among the 38 patients, the ration of males and females was 23 : 15 and the highest incidence was between the ages of 61 and 70 years.
2. The most common cause of injury was traffic accident(18 cases, 47.4%).
3. According to the Neer's classification, the most common type was two part fractures(19 cases, 50.0%).
4. Twenty five cases(65.8%) were treated by conservative treatment and 2 cases of 2-part fracutre by percutaneous pinning, and open reduction and internal fixation was done in 3 cases of 2-part fracture, all 5 cases of 3-part fracutre, 1 case of
3-part
fracture dislocation, and all 2 cases of 4-part fracture were treated by prosthetic replacement.
5. The resutls were evaluated by the Neer's criteria, 20 cases(52.7%) showed good, 11 cases(28.9%) was fair, and 7 cases(18.4%) was poor.
Over-all results were encouraging in 1-part and 2-part fractures, but disappointing results were gained in 3-part and 4-part fracutres.
6. Complications(23.6%) were developed mainly in 3-part and 4-part fractures and joint stiffness was the most common complication(15.8%).
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