Analysis The Correlation Of Treatment And Neer Classification Of The Proximal Humeral Fractures

Objective:To study the significance of the choice of proximal humeral fracture treatment about Neer classification.Methods:Between September 2009 and January 2011,24 cases of the hanging shoulder rejection for treatment,29 cases of the locking plate for treatment, a total of 53 cases of patients with proximal humeral fractures. Age 22 to 88 years, mean 62 years, one part of the fracture in 6 cases, two part fractures in 24 cases, three-part fractures in 21 cases, four-part fractures in 2 cases. The shoulder functional exercises got early after operation. Shoulder score, fracture reduction and healing time of the situation were observed and compared.Results:All of the 53 patients were carried out 3 months regular follow-up, no cases lost, and the fractures were healed. One-two part fractures about the two treatment methods for comparison, no significant difference(P>0.05).Surgery group was better than conservative group in three-four fractures(P<0.05). Conservative group and 4 weeks for the surgical group no difference in shoulder scores,8th and 12th week the conservative group with shoulder scores was better than the surgery group. Surgery group was better in fracture reduction, worse in the fracture healing time than conservative group.Conclusion:1. One-two part fractures, conservative treatment and surgical treatment were similar, so we proposed conservative treatment. Three-four part fractures, conservative treatment has some clinical effect, but need to consider the risk of complications.2. Inadequate parts in Neer typing:different observers for the determination of fracture type were different.When using the X film in Neer classification, the difficulty lies in fracture analysis of the situation, three-four part of the complex fractures with CT was necessary.The classification did not take into account of age, gender, bone quality and other issues, treatment options can not rely solely on Neer classification, the integrity of the medial cortical and bone mineral density situation of the proximal humerus should be considered. Physicians should take the patient's physical condition and limb original level of functionality into consideration. Either conservative treatment or surgical treatment has its own advantages and disadvantages. There will be a good clinical outcome if we can in correct understanding the relationship of benefits or disadvantages in selecting treatment program.