The Radiographic and Clinical Outcomes of Proximal Humerus Fractures in Patients Over 60 Years of Age

Objective: To present and compare the results of surgical methods used in the treatment of osteoporotic proximal humerus fractures (PHFs). Methods: A retrospective examination of patients who underwent surgery for osteoporotic PHF between 2009 and 2013 was conducted. The demographic data of the patients, surgical methodology, concomitant injuries, time intervals before surgery, hospitalization time, and follow-up time were recorded. Constant-Murley score and American Shoulder and Elbow Surgeons score were utilized for functional evaluation. Shoulder abduction and flexion ranges of motion were measured as objective evaluation. Results: Sixteen patients (64%) were operated with plate-screw osteosynthesis, two patients (8%) with percutaneous Kirschner wire fixation and seven patients (28%) with partial shoulder arthroplasty. A significant correlation was identified between treatment and Neer classification (P = 0.011). No significant correlation was observed between functional scores and surgical method (P > 0.05 for each). Objective evaluations revealed a significant difference in shoulder abduction range of motion between patients and surgical method (P = 0.030). Post-hoc analyses showed a significant difference between plate-screw osteosynthesis and hemi-arthroplasty groups (P = 0.010). Conclusion: Percutaneous techniques, plate-screw osteosynthesis, or arthroplasty methods may be preferred in osteoporotic PHFs, with no superiority over each other. The decision regarding the surgical method for geriatric PHFs should be based on patient -and fracture- related factors.