Proximal humeral fractures with minimal displacement treated conservatively

We reviewed 27 patients with a minimally displaced proximal humeral fracture treated conservatively after a mean follow-up of 25 (12-34) months. All fractures had united. Patients were evaluated using the Constant-Murley scoring system, and isokinetic muscle strength was tested using a Cybex dynamometer. Finally, all shoulders were examined ultrasonographically. The mean Constant score for all patients were 81 (54-100). Twenty-three patients had no or only mild pain, while three had moderate and one severe pain necessitating regular use of oral analgesics. Twenty patients were able to perform all activities of daily living, but seven had mild trouble in overhead activities and weight carrying. Only in one patient, the abduction peak torque equalled the one of the opposite shoulder. In all other patients, the peak torque was lower than, and in 14 patients below, 50%. In nine patients, rotator cuff tears were seen at ultrasonography.