Abstract
Aims: To compare retrospectively the results of percutaneous þxation, open reduction and þxation and hemi-arthroplasty in displaced proximal humerus fractures. Methods: The initial study group lost 29.50% of patients to follow-up and registered 14.75% deaths. Finally, 98 patients came back for revision and were included in the study with an average follow-up of 41 months. The hemi-arthroplasty group (H) included 34 patients, the percutaneous group (P) 32 and the internal þxation (I) 32. The average age was 55 for P group, 58 for I and 72 for H. Females represented 62% of P, 50% of I and 79% of H. Low energy fractures accounted for 62%, 63% and 78% respectively. Comorbidity in H was present in 50% of cases and associated fractures in 28%. Three and four part fractures following Neer classiþcation were present in 55% P, 55% for I and 100% for H. Results: Average elevation was 130û for P, 106û for I and 80û for H patients. Selecting only three and four part fractures, elevation was 105û in P, 104û in I and 80û in H. Constant score reached in average 81 points in P, 68 in I and 57 in H. For three and four part patients mean Constant was 74, 68 and 57 respectively. VAS with daily activities was 0.6 for P, 2.3 for I and 3.8 for H. Good and average radiological reduction was achieved in 55% of P and I groups and 12.5% osteonecrosis developed in I but none in P. Conclusions: Percutaneous þxation represents a good surgical option comparable to open reduction and þxation. Hemiarthroplasty only achieves modest functional results but patients have quite different epidemiological data.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
