Journal of Musculoskeletal Trauma

Original Articles

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.

A Operative treatment of the three-part, four-part Fracture and Fracture dislocation in proximal humerus: Young Su Lee, Min Ki Kim; J Korean Soc Fract 1997;10(1):112-118. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.112

Abstract PDF: The three part, four part fracture and fracture-dislocation of proximal humerus generally need operative treatment but treatment of these fractures has remained controversal. The purpose of this study is to analyze the result of operative treatment of three-part, four-part fracture and fracture dislocation in proximal humerus. From Jan 1990 to July 1995, Eleven patiens were reviewed and the result were summerized as follows. 1. There were 4 three-part fracture, 1 four-part fracture, 4 three-part fracture-dislocation, 1 head-spliting fracture, 1 impression fracture. 2. Open reduction and internal fixation was done in 7 cases, prothetic replacement was done in 4 cases. 3. The result were analyzed accroding to scoring system of Neer. 1) The excellent or satisfactory result were seen in 5 cases of three part fracture and fracture-dislocation, but in none case of four-part fracture. 2) The excellent or satisfactory result were seen in 3 cases with open reduction and internal fixation, and in 3 cases with prothetic replacement. 4. Among the cases with joint disability(5), there are 1 three-part fracture-dislocation, 1 head-spliting, 2 three-part fracture, 1 four-part fracture. 5. The rigid fixation and early mobilization is considered to be a good modality.

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