Journal of Musculoskeletal Trauma

Comparative study between operative and conservative treatment in 3 part and 4 part fracture of the proximal humerus: Chang Hyuk Choi, Kwoing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Dong Kyu Shin, Bum Jin Park; J Korean Soc Fract 2000;13(2):390-396. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.390

Abstract PDF: PURPOSE
: Majority of 3-part and 4-part fracture of proximal humerus had been treated by surgical methods. However, Surgical treatment might be inappropriate due to the medical status or combined injures if the patients. Therefore, we compared the operative treatment with the conservative treatment in 3-part and 4-part fracture of proximal humerus.
MATERIALS AND METHODS
: Among the 39 cases of 3-part(30) and 4-part(9) fracture of proximal humerus, 22 cases(57%) were treated by conservative methods and 17 cases(43%) were treated by operative methods with T-plate, wire, arthroplasty and screw.
RESULTS
: Among 30 cases of 3-part fracture of proximal humerus, according to the Neer's functional criteria, 12cases(60%) had excellent or satisfactory result in conservative treatment and 7cases(70%) had excellent or satisfactory result in operative treatment. In 9 cases of 4-part fracture of proximal humerus, 2 cases(100%) had poor result in conservative treatment, and 5 cases(71%)had excellent or satisfactory result in operative treatment.
CONCLUSION
: There was no difference in functional result according to the treatment modality in 2-part fracture(p>0.05). but in 4-part fracture, we prefer to treat by operative methods due to avascular necrosis at humeral head and poor functional result with conservative treatment.

Treatment of Surgical Neck Fracture and Fracture Dislocation in Proximal Humerus: Sung Ill Baek, Eea Sub Chung; J Korean Soc Fract 1997;10(4):897-903. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.897

Abstract PDF: The management of the two part surgical neck fracture, three part fracture and fracture-dislocation of proximal humerus is still under debate. Various method of internal fixation have been reported but none of these methods have been consistently successful. The purpose of this study is to analyze the result of open reduction and internal fixation surgical neck fracture, three-part fracture and fracture-dislocation in proximal humerus. From Janunary. 1991 to July 1996, fifteen patiens were reviewed and the result were summerized as follows. 1. There were 8 two-part surgical neck fracture, 3 three-part fracture, 4 three-part fracture-dislocalion. 2. The results were analyzed accroding to scoring system of Neer; the excellent or satis-factory results were seen in 11 cases, but unsatisfactory results were seen in 4 cases. 3. Complication occured as follows; joint disability in 4 cases, high positioning of plate in 1 case of joint disability. 4. We concluded that T-plate offers satisfpctory reduction and good stability at high risk of joint disability. Early mobilization is required in the prevenion of joint disability of shoulder.

Operative Treatment of Three Part Fraetures of the Proximal Humerus Following AO/ASIF Principle: Key Yong Kim, Choon Sung Lee, Sung Il Bin; J Korean Soc Fract 1992;5(2):342-347. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.342

Abstract PDF: The three part fractures of proximal humerus are not uncommon and the management is still under debate. For the good functional result, rigid internal or external fixation and early ROM exercise is mandatory. From Oct, 1989 to Oct, 1991, the results of treatment of 13 cases of proximal humerus 3-part fractures exclusively treated by internal fixation following the principles of the AO/ASIF group were analyzed at the Department of Orthopedic Surgery, Asan Medical Center. The results were as follows ; 1. The major cause of injury was traffic accident(9 out of 13 cases). 2. The associated injuries were brachlal plexopathy(1), rib fractures(1) and femur fractures (1). 3. The types of fractures were type B(7 cases), and type C(6 cases) according to AO/ASIF classification. 4. Open reduction and internal fixation was performed with T plate and tension band wiring, if necessary. 5. The excellent results were 4 cases and satisfactory results were 5 cases according to Neer criterla.

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