title: Treatment of displaced proximal humeral fractures in elderly patients.
abstract: We randomised 40 elderly patients of mean age 74 years with displaced three- or four-part fractures of the humerus to either conservative treatment or tension-band osteosynthesis. At one year and after three to five years, clinical follow-up showed no functional differences between the two groups of patients, with optimal function achieved within one year. There were major complications only in the surgically-treated group. Radiological review showed that surgery had improved the position of the fractured humeral head, but this was not reflected in improved function. Semi-rigid fixation with tension-band wiring of displaced multifragment fractures of the proximal humerus in the elderly did not improve the functional outcome when compared with conservative treatment.
authors.affiliation: Department of Orthopaedics, Söder Hospital, Stockholm, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Zyto
authors.forename: L
authors.initials: L
authors.lastname: Ahrengart
authors.forename: A
authors.initials: A
authors.lastname: Sperber
authors.forename: H
authors.initials: H
authors.lastname: Törnkvist
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000628:therapy*; D006811:Humerus / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D009989:Orthotic Devices; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D013997:Time Factors