Abstract
In 52 patients with 4-part fractures of the proximal humerus, primary prosthetic replacement of the humeral head was performed. The median age of the mainly female group of patients was 77 years. According to the Neer fracture classification, IV/4 and V/4 fractures were predominant. Subjective evaluation of the treatment results yielded good to very good results in 2/3 of the cases according to the Visual Score. The Constant Score median was 59 points (range: 40 -91 points), with our patients achieving better results for the subjective parameters pain and activity than for the objective parameters mobility and strength. Sonographic examination revealed in nearly all patients atrophied rotator cuffs associated with motor disturbance between the gliding layers. As a result of their trauma, 4 patients suffered from a persistent damage of the brachial plexus, in 1 patient a secondary dislocation of the tubercula resulted, and 2 patients developed a deep infection.
Key words
4 part fracture - humeral head - Primary arthroplasty
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Prof. Dr. med. C. Ulrich
Unfallchirurgische Klinik am Eichert
Postfach 660
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