Conservative treatment vs prosthetic replacement surgery to treat 3- and 4-fragment fractures of the proximal epiphysis of humerus in the elderly patient.

Several previous studies have revealed a significant difference in the functional results obtained between conservative treatment and prosthetic replacement surgery to treat complex fractures of the proximal end of the humerus. Thus, prosthesis is the gold standard in treatment of such fractures. It is the purpose of this study to analyze the functional results obtained with the conservative treatment of 18 consecutive patients, mean age 78 years, affected with 3- and 4-fragment fractures of the proximal epiphysis of humerus. A comparison of functional results that may be obtained when prosthetic replacement is performed does not show significant differences in this category of patients. Thus, in order to limit complications, when the patient is elderly, complex fracture of the proximal epiphysis of humerus should be treated conservatively.