Abstract
Objective To analyze the treatment of proximal humeral fractures and the prognostic factors affecting the shoulder joint functions.Methods A retrospective analysis was done for the 51 cases of proximal humeral fractures who had been treated from January 2002 to July 2005.By Neer classification, there were 2 one-part fractures, 30 two-part fractures, 13 three-part fractures, and 6 four-part fractures.Seven cases were managed with conservative therapy of close reduction, 42 cases with open reduction and internal fixation and 2 cases with humeral head replacement(HHR).The results were evaluated by American Shoulder and Elbow Surgeon(ASES)scoring system.Univariate logistic regression and multiple stepwise logistic regression were adopted to analyze the following factors: age, sex, associated injury, complications, time interval from injury to treatment, fracture type and methods of treatment.Results They were followed up for a mean time of 37.2(19 to 67)months.The average ASES score was 82.1(36.7 to 100).The univariate logistic regression analysis showed that age, complications, and fracture type had a significant association with prognosis of shoulder function.The multiple stepwise logistic regression showed that age and fracture type were key factors affecting the shoulder function.Conclusion Since age and fracture type may be the chief prognostic factors affecting the shoulder function following a proximal humeral fracture, they should be taken into consideration for individualized treatment. Key words: Shoulder fractures; Fracture fixation, internal; Shoulder joint; Joint prosthesis; Prognosis
Published Version
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