Minimally displaced proximal humeral fractures: epidemiology and outcome in 507 cases

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Minimally displaced proximal humeral fractures are common injuries.
• The AO classification system is widely used for fracture categorization.
• Understanding factors influencing treatment outcomes is crucial for patient care.

Purpose of the Study:

• To analyze the incidence of minimally displaced proximal humeral fractures across different AO classification subgroups.
• To identify determinants of outcome following nonoperative management.
• To compare subjective and objective patient outcomes.

Main Methods:

• Retrospective analysis of 507 consecutive minimally displaced proximal humeral fractures.
• Fracture classification using the AO system.
• Patient follow-up for 1 year with Neer score assessment and return to daily activities evaluation.

Main Results:

• Significant variation in minimally displaced fracture incidence across AO subgroups (Type A, B, C).
• Type A fractures were more common in younger patients.
• 88% of 376 followed patients achieved excellent or good results with nonoperative management.
• Patient age was the primary determinant of outcome (Neer score, return to activities).
• Co-morbidities negatively impacted outcomes in some patients.
• Subjective patient satisfaction was higher in older individuals compared to objective measures.
• Physiotherapy duration influenced 1-year outcomes.

Conclusions:

• AO classification reveals variations in minimally displaced proximal humeral fractures.
• Nonoperative management yields good results in most cases, but age and comorbidities are key prognostic factors.
• Patient age influences both objective functional recovery and subjective treatment satisfaction.