上腕骨近位端骨折の治療経験　―成績不良例の検討―

概要

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The purpose of this study was to evaluate the surgical results for proximal humeral fractures by analysis of patients obtaining a poor recovery. We studied 23 patients who underwent a surgical procedure for a proximal humeral fracture and were followed-up more for than 6 months from 1987. 10 were males and 13 were females. The average age was 59 years old (34-84 years old) and the average follow-up period was 34 months. The fracture type was a 2-part fracture in 10 patients, a 3-part fracture in 4 patients and a 4-part fracture in 9 patients. We investigated the surgical results aiming at Japan Orthopaedic Association (JOA) scores and range of active elevation of the shoulder joint. The mean JOA score and the mean range of active elevation was 88 points and 125 degrees in a 2-part fracture, 79 points and 110 degrees in a 3-part and 72 points and 86 degrees in a 4-part. 9 of the patients (a 2-part fracture in 2 patients, a 3-part in 1, a 4-part in 6) obtained under 70 points of the JOA score or under 90 degrees in active elevation. 8 patients over 66 years old made significantly poorer recoveries than the 65 years old and under. The patients with poor shoulder function before injury and the elderly patients tended to obtain poor results with surgical treatments.