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Clinical and radiological evaluation of minimally displaced proximal humeral fractures

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this prospective study was to assess the Constant score and radiographic outcome in 66 patients (mean age 58.7 years/mean follow-up 51 months) with a minimally displaced and/or impacted fracture of the proximal humerus treated with early mobilization.

Method

Special attention was paid to analyze the specific intrinsic parameters (age, gender, ASA grade and length of physiotherapy), injury-related parameters (classification, osteoporosis) and therapy-related parameters (initial fracture displacement, residual bony-deformity after healing, secondary fracture displacement during healing period, non-union, humeral head necrosis and omarthrosis) that may influence the final score.

Patients

There were 31 A (47%), 22 B (33%) and 13 C-fractures (19%). The median Constant score for the fractured shoulder was 89 points.

Results

All fractures healed without non-union. The radiological assessment showed in 80% a fracture-displacement with <15° angulation and/or <5-mm displacement of the greater tuberosity. At time of follow-up, the residual bony-deformity was perfect and good in 88% of cases. There was a significant association between the final Constant score and the age, ASA classification, AO (ABC) classification and initial fracture displacement.

Conclusion

Early physiotherapy, with a short period of immobilization is a sufficient therapy for management of minimally displaced and/or impacted fractures of the proximal humerus.

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Authors and Affiliations

  1. Clinic for Traumatology and Reconstructive Surgery, Berufsgenossenschaftliche Unfallklinik Tübingen, Eberhard-Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tubingen, Germany

    Christian Bahrs, Bernd Rolauffs & Kuno Weise

  2. Clinic for Traumatology and Reconstructive Surgery, Caritas-Hospital Bad Mergentheim, Uhlandstr. 7, 97980, Bad Mergentheim, Germany

    Christoph Eingartner

  3. Department of Medical Biometry, Eberhard-Karls University, Westbahnhofstr. 55, 72070, Tubingen, Germany

    Klaus Dietz

Authors
  1. Christian Bahrs
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  2. Bernd Rolauffs
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  3. Klaus Dietz
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  4. Christoph Eingartner
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  5. Kuno Weise
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Correspondence to Christian Bahrs.

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Bahrs, C., Rolauffs, B., Dietz, K. et al. Clinical and radiological evaluation of minimally displaced proximal humeral fractures. Arch Orthop Trauma Surg 130, 673–679 (2010). https://doi.org/10.1007/s00402-009-0975-9

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  • DOI: https://doi.org/10.1007/s00402-009-0975-9

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