Follow-up study was performed in the cases of fractures and fracture-dislocations of the proximal part of the humerus and old shoulder dislocations in which different methods of surgical treatments were made. Nineteen shoulders of eighteen cases consisted of thirteen cases of fracturedislocations; four cases of two-part, two of three-part, six of four-part and one case accompanied with glenoid fracture and three cases of proximal humeral fractures; two two-part fractures and one three-part were examined. Moreover, three cases of old traumatic shoulder dislocations treated by open reduction were also analysed. Patient's age at operation ranged from nineteen to seventy-nine years old,53.1 years on the average. The patients had been followed for from six months to fourteen years and nine months; the average period of follow-up after operation was five years and two months. Internal fixation with screws or Kirschner wires was attempted in eight cases, replacement of the humeral head with Neer's type of prosthesis in folk, resection arthroplasty in five cases. In two cases of old shoulder dislocations open reduction and Bristow's operation was made.
The results of treatment was assessed according to Neer's criteria for eval u ation although an item of anatomy (10 units) was omitted from the criteria because the result had to be compared among the different methods of surgical treatment. Therefore, full score became 90 points; 35 points of pain,30 of function and 25 of range in motion.
The average points was 67.5 in the group of internal fixation which was the highest score among the four groups,61.5 in the prosthesis,49.4 in the resection arthroplasty and 66.5 in the open reduction and Bristow's operation for old shoulder dislocations. The total points in the group of prosthesis had become increasing in recent cases. The fact would be attributable mainly to the minimal detachment of the deltoid muscle by using long delto-pectoral approach advocated by Neer. On the other hand, worse results in the resection arthroplasty was caused by its restriction of range in motion.
