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The Journal of Bone and Joint Surgery 79:203-7 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Functional Outcome after Minimally Displaced Fractures of the Proximal Part of the Humerus*

KENNETH J. KOVAL, M.D.{dagger}, MAUREEN A. GALLAGHER, PH.D.{dagger}, JOSEPH G. MARSICANO, M.D.{dagger}, FRANCES CUOMO, M.D.{dagger}, ASHGAN MCSHINAWY, B.S.{dagger} and JOSEPH D. ZUCKERMAN, M.D.{dagger}, NEW YORK, N.Y.

Investigation performed at the Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York City

One hundred and four patients who had a minimally displaced fracture of the proximal part of the humerus (a so-called one-part fracture) were managed with a standardized therapy regimen and followed for more than one year. The clinical outcome was assessed on the basis of pain, function, and the range of motion of the shoulder. The duration of follow-up averaged forty-one months (range, twelve to 117 months). All fractures united without additional displacement. Eighty patients (77 per cent) had a good or excellent result, fourteen (13 per cent) had a fair result, and ten (10 per cent) had a poor result. Ninety-four patients (90 per cent) had either no or mild pain in the shoulder, eight (8 per cent) had moderate pain, and two (2 per cent) had severe pain. Functional recovery averaged 94 per cent; forty-eight patients (46 per cent) had 100 per cent functional recovery. At the time of the most recent follow-up, forward elevation of the injured shoulder averaged 89 per cent; external rotation, 87 per cent; and internal rotation, 88 per cent that of the uninjured shoulder. The percentage of good and excellent results was significantly greater (p < 0.01) and external rotation was significantly better (p < 0.01) at the time of the latest follow-up for the patients who had started supervised physical therapy less than fourteen days after the injury than for the patients who had started such therapy at fourteen days or later.


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