title: [Treatment protocol in elderly patients with three- or four-fragment proximal humerus facture at a referral center located in an emerging economy].
abstract: BACKGROUND
  Proximal humerus fractures account for 4-5% of the fractures that occur among elderly people; they represent 45% of humerus fractures, and 13-16% of them are three- or four-fragment fractures.
  
  
  METHODS
  Retrospective, observational, cross-sectional study of secondary data sources. The records of patients over 60 years of age with a diagnosis of three- or four-fragment proximal humerus fractures were analyzed. A non-probabilistic sampling technique of consecutive cases was used. The following variables were analyzed: age, sex, fragment number, limb involved and dominant limb, and treatment protocol.
  
  
  RESULTS
  118 patients were included, most of them females (83.9%), age range was 60-93 years, with a mean age of 73 years. Three-fragment fractures represented 63%, and four-fragment fractures 36%. The left limb was more frequently affected, accounting for 57%; 43% of cases were treated conservatively. Open reduction and internal fixation (ORIF) was performed in 39 cases with a tension band, in 22 patients with hemiarthroplasty, ORIF with a 4.5 T-plate in 5 patients, and ORIF with a LCP LISS plate in one patient.
  
  
  CONCLUSIONS
  Female patients over 72 years of age underwent this kind of treatment more frequently. Surgical treatment accounted for 57%, unlike what the literature reports (20%).
authors.affiliation: Servicio de Miembro Torácico, Unidad Médica de Alta Especialidad, Hospital de Traumatología y Hospital de Ortopedia "Dr. Victorio de la Fuente Narváez", Colector 15 s/n (Av. Fortuna), Esq. Av. Politécnico Nacional, Col. Magdalena de las Salinas, CP 07760, Del. Gustavo A. Madero, México, D.F.
authors.forename: D A
authors.initials: DA
authors.lastname: Núñez-Gómez
authors.affiliation: Servicio de Miembro Torácico, Unidad Médica de Alta Especialidad, Hospital de Traumatología y Hospital de Ortopedia "Dr. Victorio de la Fuente Narváez", Colector 15 s/n (Av. Fortuna), Esq. Av. Politécnico Nacional, Col. Magdalena de las Salinas, CP 07760, Del. Gustavo A. Madero, México, D.F.
authors.forename: B
authors.initials: B
authors.lastname: Hernández-Álvarez
authors.affiliation: Servicio de Miembro Torácico, Unidad Médica de Alta Especialidad, Hospital de Traumatología y Hospital de Ortopedia "Dr. Victorio de la Fuente Narváez", Colector 15 s/n (Av. Fortuna), Esq. Av. Politécnico Nacional, Col. Magdalena de las Salinas, CP 07760, Del. Gustavo A. Madero, México, D.F.
authors.forename: J M
authors.initials: JM
authors.lastname: Pérez-Atanasio
authors.affiliation: Servicio de Miembro Torácico, Unidad Médica de Alta Especialidad, Hospital de Traumatología y Hospital de Ortopedia "Dr. Victorio de la Fuente Narváez", Colector 15 s/n (Av. Fortuna), Esq. Av. Politécnico Nacional, Col. Magdalena de las Salinas, CP 07760, Del. Gustavo A. Madero, México, D.F.
authors.forename: R
authors.initials: R
authors.lastname: Torres-González
authors.affiliation: Servicio de Miembro Torácico, Unidad Médica de Alta Especialidad, Hospital de Traumatología y Hospital de Ortopedia "Dr. Victorio de la Fuente Narváez", Colector 15 s/n (Av. Fortuna), Esq. Av. Politécnico Nacional, Col. Magdalena de las Salinas, CP 07760, Del. Gustavo A. Madero, México, D.F.
authors.forename: I R
authors.initials: IR
authors.lastname: Águila-Ledesma
keywords: Fracture; elderly; proximal humerus; treatment protocol