title: Clinical and radiological evaluation of minimally displaced proximal humeral fractures.
abstract: BACKGROUND
  The purpose of this prospective study was to assess the Constant score and radiographic outcome in 66 patients (mean age 58.7 years/mean follow-up 51 months) with a minimally displaced and/or impacted fracture of the proximal humerus treated with early mobilization.
  
  
  METHODS
  Special attention was paid to analyze the specific intrinsic parameters (age, gender, ASA grade and length of physiotherapy), injury-related parameters (classification, osteoporosis) and therapy-related parameters (initial fracture displacement, residual bony-deformity after healing, secondary fracture displacement during healing period, non-union, humeral head necrosis and omarthrosis) that may influence the final score.
  
  
  METHODS
  There were 31 A (47%), 22 B (33%) and 13 C-fractures (19%). The median Constant score for the fractured shoulder was 89 points.
  
  
  RESULTS
  All fractures healed without non-union. The radiological assessment showed in 80% a fracture-displacement with <15 degrees angulation and/or <5-mm displacement of the greater tuberosity. At time of follow-up, the residual bony-deformity was perfect and good in 88% of cases. There was a significant association between the final Constant score and the age, ASA classification, AO (ABC) classification and initial fracture displacement.
  
  
  CONCLUSIONS
  Early physiotherapy, with a short period of immobilization is a sufficient therapy for management of minimally displaced and/or impacted fractures of the proximal humerus.
authors.affiliation: Clinic for Traumatology and Reconstructive Surgery, Berufsgenossenschaftliche Unfallklinik Tübingen, Eberhard-Karls University Tübingen, Schnarrenbergstr. 95, 72076 Tubingen, Germany. C.Bahrs@gmx.de
authors.forename: Christian
authors.initials: C
authors.lastname: Bahrs
authors.forename: Bernd
authors.initials: B
authors.lastname: Rolauffs
authors.forename: Klaus
authors.initials: K
authors.lastname: Dietz
authors.forename: Christoph
authors.initials: C
authors.lastname: Eingartner
authors.forename: Kuno
authors.initials: K
authors.lastname: Weise
mesh_terms: D000367:Age Factors; D004434:Early Ambulation; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D011446:Prospective Studies; D011859:Radiography; D012737:Sex Factors; D012784:Shoulder Fractures / Q000145:classification / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy