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KMID : 0386420130260040292
Journal of the Korean Fracture Society
2013 Volume.26 No. 4 p.292 ~ p.298
The Result of Conservative Treatment of Proximal Humerus Fracture in Elderly Patients
Baek Seung-Gil

Oh Chang-Wug
Byun Young-Soo
Oh Jong-Keon
Kim Joon-Woo
Yoon Jong-Pil
Lee Hyun-Joo
Kim Hyung-Sup
Abstract
Purpose: With the increase in the old age population, proximal humerus fractures have been increasing recently. However, complications after operative treatment, such as fixation failure, are common because of osteoporosis. We treated proximal humerus fractures in patients with osteoporosis conservatively, and evaluated the radiographic and functional results by analyzing the factors affecting the results.

Materials and Methods: Nineteen out of 30 cases for whom the clinical follow-up was over 1 year were included in this retrospective study. There were 17 females and 2 males, and the mean age was 73.2 years. The causes were slip from a short height (18 cases) and a minor car accident (1 case). We evaluated the union period, nonunion, malunion and the Constant score and analyzed several factors affecting the functional result, such as age, fracture pattern, and malunion.

Results: Seventeen cases (89.5%) obtained union within 12.8 weeks on average. Neck-shaft angle was 125.3o on average, with seven cases of malunion. The Constant score was 84.1 on average, and there were excellent scores in 11 cases, good scores in 4 cases, and fair scores in 2 cases. Fracture pattern, neck-shaft angle, or malunion did not affect the functional outcome, and elderly patients showed poorer shoulder function.

Conclusion: Proximal humeral fractures with osteoporosis may achieve a high rate of bony union when treated with conservative methods. Despite the common occurrence of malunion, a satisfactory functional outcome may be expected.
KEYWORD
Shoulder fracutre, Proximal humeral fracture, Aged, Conservative treatment, Osteoporosis
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