Zyto K
Department of Orthopaedics, Stockholm Söder Hospital, Karolinska Institute, Sweden.
Injury. 1998 Jun;29(5):349-52. doi: 10.1016/s0020-1383(97)00211-8.
The purpose of this retrospective study was to assess the clinical and radiographical results of non-operative treatment of displaced multifragmental fractures of the proximal humerus with a minimum follow-up of 10 years. Fifteen patients (one man, 14 women) with 17 injured shoulders were examined. The Neer classification system was used to classify the fractures, and the functional outcome was assessed using the Constant score. At the 10 year review, the mean Constant score for the patients in the three-part fracture group was 59, and 47 in the four-part fracture group. The range of motion was satisfactory with a mean flexion and abduction over 90 degrees. Only four patients reported pain and it was graded as mild. In spite of low functional scoring and poor fracture reduction in many shoulders, the patient's contentment with their injured shoulder after 10 years with high. Radiographical examination revealed severe osteoarthrosis in one shoulder, and humeral head osteonecrosis in two shoulders. Results from this study suggests that non-operative treatment of displaced three-part fractures of the proximal humerus should be considered.
本回顾性研究的目的是评估肱骨近端移位多段骨折非手术治疗的临床和影像学结果，随访时间至少为10年。对15例患者（1例男性，14例女性）的17个受伤肩部进行了检查。采用Neer分类系统对骨折进行分类，并使用Constant评分评估功能结果。在10年的复查中，三部分骨折组患者的平均Constant评分为59分，四部分骨折组为47分。活动范围令人满意，平均屈曲和外展超过90度。只有4例患者报告疼痛，且疼痛程度为轻度。尽管许多肩部功能评分较低且骨折复位不佳，但10年后患者对受伤肩部的满意度较高。影像学检查显示1例肩部有严重骨关节炎，2例肩部有肱骨头坏死。本研究结果表明，对于肱骨近端移位三部分骨折应考虑非手术治疗。
