Comminuted Fractures and Fracture-Dislocations Involving the Articular Surface of the Humeral Head

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Abstract
1 . Fractures and fracture-dislocations of the articular surface of the humeral head are severely disabling. 2. Pain is seldom a significant factor in the result (Table III). Rather, weakness, limitation of motion, and reduced endurance are the usual complaints. 3. The patient is more often satisfied with the result than is the orthopaedic surgeon who has treated him (Table V). 4. The result must be evaluated by a realistic set of criteria. Even so, the results of treatment in this study were acceptable to the examiners in only 50 per cent of the cases, and to the patients in 60 per cent of the cases. 5. Results might be improved by following the recommendations made regarding surgical technique. 6. The insertion of a prosthesis, although not yet conclusively demonstrated to be effective in solving the problems raised by this injury, is most logically considered for use in that group of comminuted fractures and fracture-dislocations which, in this series, have been treated by resection or by resection and cuff transplantation. Should the long-term results be superior, the use of a prosthesis may conceivably be advisable in the treatment of the more severely comminuted fractures of the humeral head which are now being treated by open reduction.

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