[Surgical treatment of complex fractures of the upper end of the humerus: a retrospective study of 25 cases].

Fractures of the upper end of the humerus raise a therapeutic problem in particular for three-fragment and 3 and 4-fragment complex fractures. The purpose of our study is to determine the epidemio-clinic features of complex fractures of the upper end of the humerus in adults and to assess the functional and radiological results in our case series. The study involved 25 patients whose data were collected in the Department of Orthopaedics at the Habib Bourguiba University Hospital between 2012 and 2017. We listed the epidemiological data of patients and the circumstances of the occurrence of the traumatism. Treatment was based on surgery: plate or nail osteosynthesis or prosthetics replacement. Post-operative radiographs were used to asses´ reduction. Constant-Murley score was used to assess functional outcomes at the follow-up visit. Twelve men and thirteen women were enrolled, the average age of patients was 55 years, public road accidents were reported in 48% of cases, and 4-fragment fractures were found in 76% of cases. Screwed plate osteosynthesis was used in 40% of cases and anterograde nailing was performed in 40% of cases. A prosthesis was put in place in 5 patients. Mean Constant-Murley score was 65.24, ranging between 35 years and 88 years. Consolidation of the fractures without malunions was reported in 68% of patients. In complex fractures of the upper end of the humerus, osteosynthesis performed according to patients´ needs and fracture types as well as early post-operative rehabilitation allow for acceptable functional outcomes.Domain: Orthopedic surgery.