Relationship between the functional outcomes and radiological results of conservatively treated displaced proximal humerus fractures in the elderly: A prospective study

PURPOSE: The purpose of this prospective study is to investigate the relationship between the functional outcome and the radiographic results of conservatively treated two-, three- and four-part proximal humeral fractures in patients aged over 65 years. MATERIALS AND METHODS: The study comprised 29 prospectively followed cases aged over 65 years who presented with displaced proximal humerus fracture between 2009 and 2011. The fractures were classified according to the Neer classification and all met the displacement criteria described by Neer. Standard physical therapy program was applied. Patients were evaluated clinically using Constant shoulder score, quick form of disabilities of arm, shoulder and hand score and visual analog scale. At the final follow-up, humeral head position in the coronal plane was assessed with neck-shaft angle. Any complication was recorded during the treatment period. Correlation between the functional outcomes and final radiologic results were statistically analyzed. RESULTS: Data were analyzed from 29 cases (21 female, 8 male) with a mean age was 78 ± 8.6 years (range 65-93 years). The mean follow-up period was 18.2 ± 4.07 months (range 12-26 months). Functional results were significantly related with initial fragmentation. However, there was no correlation between the functional outcomes and the final geometry of the humeral head. Despite the union occurred with deformity, the functional outcome were satisfactory. CONCLUSION: The results of this study show that initial fragmentation has a negative effect on the functional results. However, the changed position of the humeral head on coronal plane does not affect the final functional results.