期刊
JOURNAL OF SHOULDER AND ELBOW SURGERY
卷 18, 期 4, 页码 612-621出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jse.2009.03.024
关键词
Proximal humeral fracture; functional treatment; Constant score; Disabilities of the Arm; Shoulder and Hand
Background: Prospective follow-up data after nonoperative treatment for fractures of the proximal humerus are scarce. We studied functional outcomes and rates of complication and failure after conservative management of these common injuries. Materials and methods: Consecutive patients aged older than 18 years presenting to the emergency department of a large district hospital with an isolated, closed proximal humeral fracture considered suitable for functional treatment by the surgeon oil charge were enrolled in a prospective, externally monitored observational study. Surgeons were free to reduce the fracture and to prescribe any type of sling or brace. Active follow-up after 12 weeks, 6, and 12 months included plain radiographs, Constant score, and Disabilities of Arm, Shoulder and Hand (DASH) score. Results: We enrolled 160 patients (118 women; mean age. 63.3 +/- 14.8 years), and 124 completed I-year follow-up. There were 85, 71, and 4 AO 11 A B, and C fractures, and 75 one-part, 60 two-part. 23 three-part, and 2 four-part and head-splitting fractures. After I year, the mean difference in Constant scores between the injured and contralateral shoulder was 8.2 (95% confidence interval [Cl] 6.0-10.4). The mean difference in 1-year DASH scores to baseline assessment was 10.2 points (95% Cl 7.3-13.1 points). The risk of delayed and nonunion was 7.0% (95% CI, 3.6%-12.3%). Four patients subsequently underwent surgical fixation, and 5 had arthroscopic subacromial decompression. Conclusion: This study may provide reference values for future investigations and stresses ceiling effects that will make it difficult to demonstrate a significant advantage of surgical over nonoperative treatment in patients with proximal humeral fractures. Level of evidence: Level 4, Prospective case series without a control group. (C) 2009 Journal of Shoulder and Elbow Surgery Board of Trustees.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据