[Epidemiology, treatment and results of proximal humeral fractures: experience of a district hospital in a sports- and tourism area].
OBJECTIVE
The epidemiology, therapy and results of proximal humeral fractures in a touristic area were investigated and our concept for treatment presented.


METHODS
Between 1.1.1999 and 30.04.2000 adult patients with proximal humeral fractures were included, the fractures classified (Codman/Neer and AO) and results determined after an average of 9 months.


RESULTS
62 adults were treated. 59 (95 %) had an accident during leisure time, mainly skiing accidents (52 %). 7 patients (11 %) had an associated luxation of the shoulder. 51 (82 %) were treated conservatively, 11 (18 %) operatively with a T-plate. The conservatively treated had to wear a Gilchrist-cast for an average of 29 (operatively 13) days, started passive movement after 20 (operatively 9) days, and active movement after 44 (operatively 45) days. The 32 employed (52 %) were not able to work for 46 days on average. Overall, 52 patients (84 %) were totally or mostly satisfied with the result. 5 among the 13 patients (38.5 %) with 3- or 4-part-fractures, and 4 among the 11 operated patients (36.4 %) were not satisfied with the result.


CONCLUSIONS
Proximal humeral fractures are common skiing injuries, they need a long and intensive treatment and are economically expensive. The Codman/Neer and AO-classifications are equal. The results for simple, mainly conservatively treated fractures (Codman/Neer 1, 2A, 2-part) are good. Complex, mainly operatively treated fractures (Codman/Neer 3- and 4-part) have a much poorer prognosis. Diagnostically the computed tomography with 3-D-reconstruction is recommended for a better representation of the fracture and a safer choice of the therapeutical strategy.
Sonderegger
J
J
Chirurgische Abteilung, Spital Oberengadin, Samedan.
Simmen
H-P
HP
D000293:Adolescent; D000328:Adult; D000368:Aged; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D017102:Fracture Healing / Q000502:physiology; D018460:Fractures, Comminuted / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006767:Hospitals, District; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D012783:Shoulder Dislocation / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D012784:Shoulder Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D012865:Skiing / Q000293:injuries*; D013557:Switzerland / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014195:Travel