Abstract

• The three part, four part fracture and fracture-dislocation of proximal humerus generally need operative treatment but treatment of these fractures has remained controversal. The purpose of this study is to analyze the result of operative treatment of three-part, four-part fracture and fracture dislocation in proximal humerus. From Jan 1990 to July 1995, Eleven patiens were reviewed and the result were summerized as follows. 1. There were 4 three-part fracture, 1 four-part fracture, 4 three-part fracture-dislocation, 1 head-spliting fracture, 1 impression fracture. 2. Open reduction and internal fixation was done in 7 cases, prothetic replacement was done in 4 cases. 3. The result were analyzed accroding to scoring system of Neer. 1) The excellent or satisfactory result were seen in 5 cases of three part fracture and fracture-dislocation, but in none case of four-part fracture. 2) The excellent or satisfactory result were seen in 3 cases with open reduction and internal fixation, and in 3 cases with prothetic replacement. 4. Among the cases with joint disability(5), there are 1 three-part fracture-dislocation, 1 head-spliting, 2 three-part fracture, 1 four-part fracture. 5. The rigid fixation and early mobilization is considered to be a good modality.
• Key words: Proximal humerus, 3,4-part fracture and fracture-dislocation, operative treatment

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