Proximal humeral fractures: a correlation of residual deformity with long-term function

Twenty-six patients with 27 fractures of the proximal humerus were evaluated by radiographic and clinical examination (Neer rating scale) 13 months to 12 years after injury. Proximal humeral fractures that had healed with less than 55° of angulation and less than 1.5 cm of displacement of the major fracture segments had good or excellent functional results. These fractures were successfully treated with a sling or cuff and collar immobilization. Two- and three-part fractures with greater than 55° of angulation or greater than 1.5 cm of displacement had fair or poor functional results. These fractures should be reduced by closed or open methods if good or excellent results are required. Minimal (0 to 2 mm) displacement of greater tuberosity fractures was often associated with rotator cuff tears. Neither good nor excellent results were obtained in four-part, Group IV fractures treated nonsurgically.