Orthopaedic Department, Hospital Del Mar de Barcelona, Barcelona, Spain

Purpose:Optimal management of proximal humeral fractures is still to be defined. The objective of this study is to present the functional and quality of life results of proximal humeral fractures conservatively treated in elderly population.

Material and Methods: Prospective study including 74 fractures in patients over 60 and less than 85 years-old. Fractures were assessed by Xray and C.T. Exam. 4 patients lost at final follow-up.There were 14 one-part, 15 two-part greater tuberosity (GT), 17 two-part surgical neck, 10 three-part GT, 6 four-part, 6 two-part GT fracture dislocation, 1 four-part fracture dislocation and 1 impression fracture. Constant Score, EuroQol 5-D and X-Ray study at two-year follow-up. Statistics: U Mann-Whitney for           non-parametric and t-student for parametric values.

Results: Constant Score : non-displaced fractures mean of 73,58 while displaced fractures 59,41 (p0,003). Significant differences in all Constant items except for External rotation (p0,17). Constant Score diminished as fracture pattern increased complexity : 2-part GT 72,78, 2-part surgical neck 65,88, 2-part GT fracture dislocation 71, 3-part GT 54,64 and 4-part 33,66. No significant differences in pain among all displaced fractures patterns. Quality of life perception : no significant differences in VAS between displaced and non-displaced fractures (p 0,75). 4 avascular necrosis at final follow-up.

Conclusion: Conservative treatment of proximal humeral fractures give reasonable good functional results in 1-part, 2-part GT,     2-part surgical neck and 2-part GT fracture dislocation in specially selected elderly population. Limited functional result with conservative treatment in 3 and 4-part fractures.No differences between non-displaced and displaced fractures conservatively treated in quality of life perception in such elderly population.