PURPOSE To evaluate the results according to the difference of age and bone mineral density (BMD) of the surgical treatments using open intramedullary nail with tension sutures and lock suture on proximal humeral three part fracture. MATERIALS AND METHODS 30 patients treated by open intramedullary nail with tension band and lock suture technique on proximal humeral fractures were reviewed. After treatment, average follow up periods was 50 months (range; 17~143 month). Postoperative clinical outcome was evaluated using ASES functional score, Neer score and constant score. RESULTS Bony union were obtained all except one case. Range of motion, mean forward elevation was 142°, mean external rotation was 56°, mean external rotation at 90° abduction was 68°. Average pain score of visual analog scale was 1.5. Average functional score of American Shoulder and Elbow Society was 86. Average Neer score was 89. Constant score was 85. Pain and functional score of group I were better than those of group, however, there was no statistically significant difference (p>0.05). In the comparison between group III and group IV, the results were same (p>0.05). CONCLUSION The patients treated using open intramedullary nailing, tension band and lock suture could enable early ROM exercise and show good clinical results. This treatment method will be useful in old age osteoprorotic patients.
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Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures Chung Hee Oh, Joo Han Oh, Sae Hoon Kim, Ki Hyun Jo, Sung Woo Bin, Hyun Sik Gong Journal of the Korean Fracture Society.2008; 21(3): 213. CrossRef
PURPOSE The current study is performed to evaluate the clinical outcomes of treatment for two part or three part fractures of proximal humerus.
MATERIAL AND METHODS: Forty-five cases that followed up over 6 months were divided into three groups : conservative treatment(Group I, 16 cases), closed reduction with internal fixation(Group II, K-wire 10, schanz pin 4, cancellous screw 3, 17 cases) and plate and screw fixation(Group III, 12 cases). The range of motion, pain index with self assessed functional score, anatomical reduction and bone union period and complications were examined. RESULTS The range of motion was worst in group I, and anatomical reduction was best in group III. The functional score of group II(average 80), group III(average 73) were higher than group I, but there were no significant differences between group II and group III. Complications were noted in 17 cases, which occured mostly in group I and III. Avascular necrosis of humerus head was noted in one case of group II. Bone union period was average 10.4 weeks. CONCLUSION If anatomical reduction could be obtained by closed reduction and internal fixation with K-wire, schanz pin and cancellous screw in 2 part or 3 part proximal humerus fracture, it would provide a sufficient fixation for early rehabilitation and bone union, while minimizing complications.