Relationship between the functional outcomes and radiological results of conservatively treated displaced proximal humerus fractures in the elderly: A prospective study

Abstract

Purpose:The purpose of this prospective study is to investigate the relationship between the functional outcome and the radiographic results of conservatively treated two-, three- and four-part proximal humeral fractures in patients aged over 65 years.Materials and Methods:The study comprised 29 prospectively followed cases aged over 65 years who presented with displaced proximal humerus fracture between 2009 and 2011. The fractures were classified according to the Neer classification and all met the displacement criteria described by Neer. Standard physical therapy program was applied. Patients were evaluated clinically using Constant shoulder score, quick form of disabilities of arm, shoulder and hand score and visual analog scale. At the final follow-up, humeral head position in the coronal plane was assessed with neck-shaft angle. Any complication was recorded during the treatment period. Correlation between the functional outcomes and final radiologic results were statistically analyzed.Results:Data were analyzed from 29 cases (21 female, 8 male) with a mean age was 78 ± 8.6 years (range 65-93 years). The mean follow-up period was 18.2 ± 4.07 months (range 12-26 months). Functional results were significantly related with initial fragmentation. However, there was no correlation between the functional outcomes and the final geometry of the humeral head. Despite the union occurred with deformity, the functional outcome were satisfactory.Conclusion:The results of this study show that initial fragmentation has a negative effect on the functional results. However, the changed position of the humeral head on coronal plane does not affect the final functional results.

Study of outcomes of the proximal humerus fractures treated by various modalities

“…In the present study, 32 (64%) patients were injured by domestic fall, 6 (12%) patients had history of fall from height while 12(24%) patients had Road traffic accident as mode of injury. This finding corresponded with the incidence rate in literature like Koval et al [17] , Canbora et al [9] , Resch et al [10] , Aggarwal et al [15] and M. EI Sayed et al [14] . Out of 35 patients treated conservatively, 11 (31.42%) had excellent outcome, 16 (45.71%) had good outcome, 5 (14.28%) patients had fair outcome and 3 (8.57%) had poor outcome.…”

“…Out of 35 patients treated conservatively, 11 (31.42%) had excellent outcome, 16 (45.71%) had good outcome, 5 (14.28%) patients had fair outcome and 3 (8.57%) had poor outcome. Similar results have been noted in literature by Young and collegues [7] , Gaebler et al [8] , Canbora et al [9] and others. Most of fractures proximal humerus, found to be undisplaced and conservative modality was treatment of choice in such patients.…”

Clinico-radiological and functional outcome of Neer’s 2 part, 3 part and 4 part proximal humeral fractures in elderly treated by conservative management in a tertiary care centre of North India

“…Canbora et al2013. 29 20.8±2.8 (range: 16-24) Present study 18.4 (range: 13-24) 21 94 87 Oleurd et al 2011. 11 111 106 Zyto et al 1998.…”

“…25 74 -Canbora et al 2013. 29 78±8.6 18.2±4.07 Marieke et al 2017. 32 77±7.0 47±30.3 Present study 76.8 12-18…”

Proximal humerus fractures

“…Occasionally, translation may occur. Others argue that the amount of translation and varus angulation should dictate when surgical management is needed (Sudkamp et al, 2011;Canbora et al, 2013). Many authors, therefore, recommend nonsurgical management for all two-part surgical neck fractures (Hanson et al, 2009;Yuksel et al, 2011).…”