• Cem Çelik, Seyit Ali Gümüştaş, Gültekin Sıtkı Çeçen, Güven Bulut, and Halil İbrahim Bekler.
• Department of Orthopaedic and Traumatology, Geyve State Hospital, Sakarya-Turkey.
• Ulus Travma Acil Cer. 2016 Jul 1; 22 (4): 379-85.

BackgroundThe present objective was to retrospectively evaluate factors affecting functional outcome of multipart proximal humeral fracture treated with fixation or hemiarthroplasty.MethodsIncluded were 58 patients (19 women, 39 men; average age: 51.04 years; range 22-78 years) who underwent surgery for Neer type III or IV proximal humeral fractures between 2007 and 2012. All participants attended follow-up of at least 2 years. A total of 35 patients underwent open reduction and anatomical plate fixation; 23 underwent partial shoulder replacement. Patients were evaluated according to Constant-Murley shoulder scoring at final follow-up examination. Evaluated impacts on functional outcome included age, gender, American Society of Anesthesiologists (ASA) Physical Status classification, trauma energy, type of fracture, and time to surgery.ResultsMean follow-up duration was 47.25±13.29 (25-76) months. Mean Constant-Murley score was 58.65±18.62 (65.77±18.67 for the fixation group, 47.82±12.52 for the hemiarthroplasty group; p=0.001). When impact of independent variables on functional scores was assessed, ASA score and type of fracture were found to significantly affect functional outcome in the fixation group, and trauma energy was found to significantly affect functional outcome in the hemiarthroplasty group. Complications were detected in 20 patients (34.5%) upon final examination, 14 of whom (70%) had rotator cuff deficiency.DiscussionThough improved functional results may be obtained using plate fixation in the surgical treatment of multipart proximal humeral fractures, the high rates of rotator cuff failure associated with both surgical methods should be considered.

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