2001 年 25 巻 3 号 p. 483-486
[Purpose] Fractures of the proximal humerus in Neer group III (two part) are commonly treated well by the conservative treatments. However, in some cases of severe displacement of these fractures, we have performed the surgical treatment. This study is a review of evaluating the therapeutic results of the anatomical plate fixation for the fractures.
[Materials and methods]We treated nine patients (five males and four females) with a mean age of forty-four (twenty-two to sixty-seven). One of them was a nonunion case. None of the case could be reduced and maintained stabilized fractures by closed reduction as the initial treatment. Our surgical procedure was performed by using an anatomical plate on these patients. Surgical treatment was done eight to 240 days after the injury. We evaluated the results by the Japan Orthopaedic Association (JOA)score.
[Results] Bone union was accomplished at a mean time of 19.4 weeks (thirteen to twenty-five weeks)in all cases without a nonunion, a necrosis of the humeral head or infection. The range of motion of the affected side was a mean degree of 164° (105 to 180°) in flexion and 158°(ninety-five to 180°) in abduction. The JOA score was a mean of 90.5 points (seventy-nine to ninety-six points). There was only one complication that one of the patients had a new fracture of the humeral shaft at the distal side of the anatomical plate one month after operation.
[Conclusion] We recommended to perform the surgical treatment using an anatomical plate on the patients with fractures of the proximal humerus, whose fracture were classified as two part fracture using the Neer's criteria.