Resumen

NUNEZ-GOMEZ, DA et al. Treatment protocol in elderly patients with three- or four-fragment proximal humerus facture at a referral center located in an emerging economy. Acta ortop. mex [online]. 2015, vol.29, n.4, pp.207-211. ISSN 2306-4102.

Background: Proximal humerus fractures account for 4-5% of the fractures that occur among elderly people; they represent 45% of humerus fractures, and 13-16% of them are three- or four-fragment fractures. Methods: Retrospective, observational, cross-sectional study of secondary data sources. The records of patients over 60 years of age with a diagnosis of three- or four-fragment proximal humerus fractures were analyzed. A non-probabilistic sampling technique of consecutive cases was used. The following variables were analyzed: age, sex, fragment number, limb involved and dominant limb, and treatment protocol. Results: 118 patients were included, most of them females (83.9%), age range was 60-93 years, with a mean age of 73 years. Three-fragment fractures represented 63%, and four-fragment fractures 36%. The left limb was more frequently affected, accounting for 57%; 43% of cases were treated conservatively. Open reduction and internal fixation (ORIF) was performed in 39 cases with a tension band, in 22 patients with hemiarthroplasty, ORIF with a 4.5 T-plate in 5 patients, and ORIF with a LCP LISS plate in one patient. Conclusions: Female patients over 72 years of age underwent this kind of treatment more frequently. Surgical treatment accounted for 57%, unlike what the literature reports (20%).

Palabras llave : Fracture; proximal humerus; treatment protocol; elderly.

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