title: [Proximal humerus fractures: clinical assessment and functional outcome in patients with osteonecrosis of the humeral head].
abstract: BACKGROUND
  Fractures of the proximal humerus resulting in three or more fragments represent a high risk of necrosis. The former is the second most frequent site of necrosis, only after the femur, due to either traumatic or nontraumatic causes. The former are the most common, with an incidence rate of necrosis of 13-34% in fractures with more than four fragments. The purpose of this study is to assess the functional outcome of patients with a history of fracture of the proximal humerus and osteonecrosis treated conservatively.
  
  
  METHODS
  This is a descriptive, retrospective, observational study with a 6-12 month follow-up of patients older than 60 years of age with a diagnosis of fracture of the proximal humerus managed conservatively between January 2004 and November 2009. One hundred and twenty-two patients met the inclusion criteria and 12 were lost to follow-up. Mean age was 71.02 years with a range between 60 and 92 years; 41 males and 69 females. The DASH and CONSTANT scales were applied.
  
  
  RESULTS
  After applying the functional assessment scales and validating the results, the correlation coefficient obtained was 0.80, and it was statistically significant.
  
  
  CONCLUSIONS
  Conservative treatment should be used only in patients who meet the necessary criteria. Depending on the type of fracture and the patient's characteristics, treatment should always be aimed at stabilization, early mobilization, and early functional recovery. This study found that fractures treated conservatively eventually develop some degree of osteonecrosis of the head, but they have proper function, similar to that of a healthy limb.
authors.forename: J G
authors.initials: JG
authors.lastname: Gómez-Mont Landerreche
authors.forename: F
authors.initials: F
authors.lastname: Gil-Orbezo
authors.forename: H
authors.initials: H
authors.lastname: Morales-Domínguez
authors.forename: A
authors.initials: A
authors.lastname: Flores-Carrillo
authors.forename: G
authors.initials: G
authors.lastname: Levy-Holden
authors.forename: P
authors.initials: P
authors.lastname: Capuano-Tripp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058430:Humeral Head / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000150:complications / Q000628:therapy*