title: [Operative treatment of displaced proximal humeral fractures: follow-up and analysis of 31 patients'].
abstract: OBJECTIVE
  To study the methods and the results of operative treatment of displaced proximal humeral fractures.
  
  
  METHODS
  We reviewed thirty-one patients who had been diagnosed as having displaced proximal humeral fractures and had been operated on from July 1989 to December. 1998 in our hospital. The mean follow-up time was 40.5 months (8 - 124 months). Their age ranged from 15 to 62 years (average, 36.8 years); 18 patients were male and 13 female. Neer fracture classification system and rating system were used. In all patients, delto-pectoral approach was adopted. Twelve fractures were fixed with plates, fifteen fractures with screws, and four fractures with Kirschner wire and plaster.
  
  
  RESULTS
  Of two-part surgical neck fractures, nine of thirteen patients (69%) were excellent or good with no necrosis and un-union. In three-part or four-part fractures, the rate of satisfaction with open reduction and internal fixation (ORIF) was rather lower. In three-part fractures, the rate of humeral head necrosis was 44%, and in four-part fractures, over 75%.
  
  
  CONCLUSIONS
  In two-part and three-part fractures, ORIF is a better treatment, but care should be taken to avoid using plates. As for classic four-part fractures, the rate of satisfaction with ORIF is poor and the rate of necrosis is higher.
authors.affiliation: Department of Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Huang
authors.forename: X
authors.initials: X
authors.lastname: Jiang
authors.forename: X
authors.initials: X
authors.lastname: Geng
authors.forename: M
authors.initials: M
authors.lastname: Wang
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000601:surgery*