The Treatment For Comminuted Fractures Of The Proximal Humerus In The Elderly

Objective:Explore the treatment and clinical outcomes about proximal humerusfracture(Neer classification of3,4part fractures) of the elderly. Method:From2005to2012,at Xinjiang Medical University,47old patients with proximal humeral comminutedfracture were selected and analyzed retrospectively to evaluate the treatment results(Neerclassification of3,4-part fractures, of which40cases were followed up).15males and25females,The average age was71.2years(range,65-82years).we analyzed the resultsaccording to the Constant-Murley shoulder function evaluation method,20patients ingroup A were treated with humeral head replacement. However,20patients in group Buse conservative methods.Result:After22months,the Costant-Murely (A:60.85±6.63,B:56.60±6.07) and pain score (A:10.75±4.38, B:8.00±2.99) of the two group weremore significant difference, p <0.05.but the postoperative inotropic (A:15.00±3.24, B:15.00±3.63), ADL score (A:12.40±1.54B:12.00±1.45) and ROM score (A:23.70±2.62, B:22.0±3.24) showed on no significant difference, p>0.05.The patients,postoperative excellent rate of the two gruops were0.45(A) and0.40(B), the differencewas not statistically significant (p=0.263).Conclusion:For the complex proximalhumerus fractures of the elderly,humeral head replacement surgery for postoperativeshoulder function recovery is not obvious, conservative treatment should be the fristconsidered program.