抄録
The purpose of this study was to analyze factors inducing poor outcomes of Neer's minimal displacement (1-part) fractures of the proximal humerus. The subjects were 183 patients with one-part fracture, including initial and follow-up X-rays and results of shoulder motion at the final follow-up, in the JSS database of proximal humeral fractures. There were 134 females and 49 males whose average age was 60.6 years old. Surgical neck (SN) fracture was observed in 88 patients, greater tuberosity (GT) fracture in 57 patients, and SN-GT fracture in 38 patients. 3 groups classified according to results of shoulder elevation were as follows: excellent (E) group (150° or more) in 97 patients, good (G) group (90 to 150°) in 62 and fair (F) group (90° or less) in 24. Factors induced poor outcomes were analyzed and compared between the 3 groups. The average age of the E-group was significantly lower than that of the G-group or the F-group. With regard to fracture type, 91.2% of GT fractures, 97.4% of SN-GT fractures and 79.5% of SN fractures belonged to the E-group or the G-group. Varus displacement at the final follow-up increased in 66.7% of the patients with SN fractures of the F-group. 10 patients who had suffered from complications or other diseases such as dementia or rotator cuff tears obtained poor outcomes. This study suggested that treatment and rehabilitation should be applied to patients with 1-part proximal humeral fractures in consideration of the patients' backgrounds and fracture types.
