Journal of Musculoskeletal Trauma

Original Articles

Treatment and Functional Results of the Three and Four Part Fractures of Proximal Humerus: Dong Chul Lee, Hwan Jin Jeon, Jae Sung Seo; J Korean Soc Fract 2000;13(4):970-977. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.970

Abstract PDF: PURPOSE
The current study was performed to evaluate the treatment and functional results of the three and four part fractures of proximal humerus.
MATERIALS AND METHODS
Nineteen patients with displaced 3 part and 4 part fractures and fractures-dislocation were followed for more than one year and analyzed. The causes of injuries, classification of fracture, associated injuries, functions, results of treatment and complications were investigated.
RESULTS
According to Neer's classification, there were 15 cases of 3 part fracture and 4 cases of 4 part fractures. The range of motion and functional results of the shoulder in 3 part fractures (flexion 138.6degrees , abduction 124.3degrees , Constant score 60.3) were better than 4 part fractures (flexion 77.5degrees , abduction 60degrees , Constant score 29.5). We compared the humeral offset of injured side with the healthy one. In the cases of less than 4mm difference, the range of motion was 150degrees in flexion and 40.3degrees i n abduction, and the constant score was 67.3. But in the cases of more than 4mm difference, the range of motion was 84.3degrees in flexion and 58.6degrees in abduction, and constant score was 30.9 points. Clinical results was better in the cases of less than 4mm difference.
CONCLUSION
Range of motion and functional results of 3 part fractures were better than 4 part fractures and restoration of humeral offset resulted in better clinical results.

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Factors Affecting the Functional Result of Monteggia Fractures in Adults: Yong Bum Park, Byeong Ki Lee, Kwang Won Lee, Whoan Jeang Kim, Ha Yong Kim, Jae Hoon Ahn, Won Sik Choy; J Korean Soc Fract 2000;13(3):597-604. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.597

PURPOSE
Monteggia fracture is a combination of ulnar fracture and radial head dislocation. Despite of low incidence, Monteggia fracture has a problem in the treatment. So satisfactory results could not be achieved easily. The purpose of this study was to analyze factors affecting functional results in Monteggia fracture.
MATERIALS AND METHODS
From January 1990 to June 1998, we retrospectively reviewed 24 patients out of 40 patients who had been treated for Monteggia fracture. The functional assessment was performed with Broberg and Morrey system10).
RESULTS
Excellent and good results were achieved in 16 cases(66.6%), whereas fair and poor results in 8 cases(33.4%). Satisfactory results were obtained in 66.6% overall. According to the Bado classification, functional results were not different significantly between types. According to the mechanisms of injury, unsatisfactory results were obtained in 8 of 17 patients with high energy injury. Monteggia fractures with ulnar fracture at the diaphyseal level showed satisfactory results significantly compared to others. In terms of the methods of internal fixation, the plate and screw fixation showed satisfactory results in 14 of 16 patients whereas tension band wiring or intramedullary nailing showed unsatisfactory results in 6 of 8 patients.
CONCLUSION
In Monteggia fractures, factors affecting functional result may be the mechanism of injury, the level of ulnar fracture and the method of internal fixation.

Citations

Citations to this article as recorded by

Incomplete Anterior Interosseous Nerve Palsy That Accompanied a Monteggia Fracture
Bo-Kyu Yang, Seong-Wan Kim, Seung-Rim Yi, Young-Jun Ahn, Jung-Ho Noh, Young-Hak Roh, Seung-Won Lee, Min-Soo Je, Seok-Jin Kim
Journal of the Korean Orthopaedic Association.2011; 46(1): 78. CrossRef

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