Stableforth P G
J Bone Joint Surg Br. 1984 Jan;66(1):104-8. doi: 10.1302/0301-620X.66B1.6693466.
Four-part fractures of the upper end of the humerus are uncommon injuries and there is still dispute about the best form of management. A retrospective study of 32 patients with these injuries has shown that non-operative management is frequently followed by persistent pain, stiffness and dysfunction of the shoulder. A prospective study of 49 patients with this injury presenting at the Bristol Royal Infirmary has shown that reconstruction of the upper end of the humerus with insertion of a Neer prosthesis will usually restore comfort and function. Whichever regimen is employed, disability is prolonged and dedicated physiotherapy is essential in their management.
肱骨上端的四部分骨折是罕见的损伤，对于最佳治疗方式仍存在争议。对32例此类损伤患者的回顾性研究表明，非手术治疗后肩部常持续存在疼痛、僵硬和功能障碍。对布里斯托尔皇家医院收治的49例该损伤患者的前瞻性研究表明，植入Neer假体重建肱骨上端通常可恢复舒适度和功能。无论采用哪种治疗方案，残疾时间都会延长，在治疗过程中专门的物理治疗至关重要。
