Seung-Gil Baek; Chang-Wug Oh; Young-Soo Byun; Jong-Keon Oh; Joon-Woo Kim; Jong-Pil Yoon; Hyun-Joo Lee; Hyung-Sub Kim

doi:10.12671/jkfs.2013.26.4.292

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Original Article
The Result of Conservative Treatment of Proximal Humerus Fracture in Elderly Patients: Seung-Gil Baek, M.D., Chang-Wug Oh, M.D., Ph.D., Young-Soo Byun, M.D., Ph.D., Jong-Keon Oh, M.D., Ph.D., Joon-Woo Kim, M.D., Ph.D., Jong-Pil Yoon, M.D., Hyun-Joo Lee, M.D., Hyung-Sub Kim, M.D.; Journal of the Korean Fracture Society 2013;26(4):292-298.
DOI: https://doi.org/10.12671/jkfs.2013.26.4.292
Published online: October 18, 2013

Department of Orthopedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

^*Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Korea.

^†Department of Orthopedic Surgery, Korea University College of Medicine, Seoul, Korea.

Address reprint requests to: Chang-Wug Oh, M.D., Ph.D. Department of Orthopedic Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro Jung-gu, Deagu 700-721, Korea. Tel: 82-53-420-5630, Fax: 82-53-422-6605, cwoh@knu.ac.kr

• Received: May 31, 2013 • Revised: July 16, 2013 • Accepted: August 20, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

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.
Conclusion
Proximal humeral fractures with osteoporosis may achieve a high rate of bony union when treated with conservative methods. Despite the common occurrence of malunion, a satisfactory functional outcome may be expected.
Key words: Shoulder fracutre, Proximal humeral fracture, Aged, Conservative treatment, Osteoporosis

REFERENCES

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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.

Fig. 3

(A) An 84-year-old female sustained a proximal humerus fracture (AO/OTA 11-A2).

(B) Reduction was achieved.

(C) At 12 weeks, bony union was obtained, with varus deformity.

(D) At 4 years, the patient showed a good functional outcome with mildly limited movements of the shoulder.

Table 1

Summary of Cases

Figure & Data

REFERENCES

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The Result of Conservative Treatment of Proximal Humerus Fracture in Elderly Patients

J Korean Fract Soc. 2013;26(4):292-298. Published online October 31, 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.4.292

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The Result of Conservative Treatment of Proximal Humerus Fracture in Elderly Patients

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.

Fig. 3 (A) An 84-year-old female sustained a proximal humerus fracture (AO/OTA 11-A2). (B) Reduction was achieved. (C) At 12 weeks, bony union was obtained, with varus deformity. (D) At 4 years, the patient showed a good functional outcome with mildly limited movements of the shoulder.

Fig. 1

Fig. 2

Fig. 3

The Result of Conservative Treatment of Proximal Humerus Fracture in Elderly Patients

Table 1

Summary of Cases

Table 1 Summary of Cases