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 pose a therapeutic problem, particularly for complex fractures with 3 and 4 fragments. The objective of this study is to determine the epidemiological-clinical characteristics of complex fractures of the upper end of the humerus in adults and to assess the functional and radiological outcomes of our series. This series consists of 15 cases collected at the orthopedics department of CHU Ibn Sina between 2021 and 2015. We recorded the epidemiological data of the patients and the circumstances of the trauma. The treatment was primarily surgical, either plate synthesis or nail fixation. The reduction was evaluated based on postoperative X-rays. At follow-up, functional results were assessed using the Constant score. Our series includes 8 men and 7 women, with an average age of 57 years; traffic accidents were noted in 48% of cases, and 4-fragment fractures were found in 76%.des cas. Plate osteosynthesis was used in 40% of cases and anterograde nailing was performed in 40% of cases. The average Constant score was 65.24 with extremes ranging from 35 to 88. We noted consolidation of fractures without malunion in 68%. In complex fractures of the proximal humerus, appropriately indicated osteosynthesis based on the patient and the fracture, along with early postoperative rehabilitation, results in acceptable functional outcomes.