Citation

Sonderegger J, Simmen HP. Zentralbl. Chir. 2003; 128(2): 119-124.

Vernacular Title

Epidemiologie, Behandlung und Ergebnisse von proximalen Humerusfrakturen.

Affiliation

Chirurgische Abteilung, Spital Oberengadin, Samedan.

Copyright

(Copyright © 2003, Georg Thieme Verlag)

DOI

10.1055/s-2003-37765

PMID

12632279

Abstract

AIM OF THE STUDY: The epidemiology, therapy and results of proximal humeral fractures in a touristic area were investigated and our concept for treatment presented. METHODS: Between 1.1.1999 and 30.04.2000 adult patients with proximal humeral fractures were included, the fractures classified (Codman/Neer and AO) and results determined after an average of 9 months. RESULTS: 62 adults were treated. 59 (95 %) had an accident during leisure time, mainly skiing accidents (52 %). 7 patients (11 %) had an associated luxation of the shoulder. 51 (82 %) were treated conservatively, 11 (18 %) operatively with a T-plate. The conservatively treated had to wear a Gilchrist-cast for an average of 29 (operatively 13) days, started passive movement after 20 (operatively 9) days, and active movement after 44 (operatively 45) days. The 32 employed (52 %) were not able to work for 46 days on average. Overall, 52 patients (84 %) were totally or mostly satisfied with the result. 5 among the 13 patients (38.5 %) with 3- or 4-part-fractures, and 4 among the 11 operated patients (36.4 %) were not satisfied with the result. CONCLUSIONS: Proximal humeral fractures are common skiing injuries, they need a long and intensive treatment and are economically expensive. The Codman/Neer and AO-classifications are equal. The results for simple, mainly conservatively treated fractures (Codman/Neer 1, 2A, 2-part) are good. Complex, mainly operatively treated fractures (Codman/Neer 3- and 4-part) have a much poorer prognosis. Diagnostically the computed tomography with 3-D-reconstruction is recommended for a better representation of the fracture and a safer choice of the therapeutical strategy.

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