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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 125.3° 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.
Figures and Tables
Fig. 1
(A) An 80-year-old female using a shoulder immobilizer with an appropriate axillary pad.
(B) An antero-posterior radiograph shows well-maintained reduction of the fracture during use of a shoulder immobilizer with axillary pad.
Fig. 2
(A) A 78-year-old female with a displaced proximal humerus fracture (AO/OTA 11-A2).
(B) Satisfactory reduction was achieved.
(C) After 16 weeks, bony union was obtained, with acceptable alignment.
(D) At 1 year, the patient had almost full recovery of her shoulder movements with a Constant score of 93 points.
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