PURPOSE: The aim of this study was to evaluate the short- and medium-term results of non-operative treatment of four-part @entity174 of the proximal end of the humerus. The initial hypothesis was that non-operative treatment of @entity174 with @entity306 or no displacement is equivalent or superior to surgical treatment, and that non-operative treatment is probably insufficient for displaced @entity174 . METHODS: This was a multicentric, prospective and retrospective study, based on 384 four-part proximal humerus @entity174 , 58 of which involved non-operative treatments - 37 in the prospective study (Pro-CT4) and 21 in the retrospective study (Retro-CT4). The average @entity1 age was 64 +/- 14  years (39-90); 66  % were female and 34  % male. In 88  % of these cases, non-operative treatment was chosen for the @entity174 , as there was @entity306 or no displacement. In 10  % of cases, non-operative treatment was chosen "by default", due to the @entity1 's medical conditions, as surgery was contraindicated, and in 2  % of cases due to the @entity1 refusing surgery. All @entity1 were reviewed clinically and radiologically, with @entity12432 evaluation, absolute and weighted Constant scores and the Quick DASH score all assessed. The main evaluation criterion was the weighted Constant score which was considered a failure when below 70  %. RESULTS: In the Pro-CT4 study, the average follow-up period was 11 +/- four  months (5-18) with functional scores as follows: average @entity12432 : 72 +/- 26  % (8-100); average Constant score: 65 +/- 21 points (21-95); average weighted Constant score: 86 +/- 26  % (32-130); average Quick DASH: 23 +/- 21 (0-64). 27  % of @entity1 had a weighted Constant score below 70  %. In the Retro-CT4 study, the average follow-up period was 38 +/- 13  months (18-62) with functional scores as follows: average @entity12432 : 73 +/- 17  % (30-100); average Constant score: 68 +/- 18 points (33-95); average weighted Constant score: 88 +/- 27  % (47-133); average Quick DASH: 18 +/- 16 (0-48); 24  % of @entity1 had a weighted Constant score below 70  %. CONCLUSION: This study confirms our initial hypothesis. When non-operative treatment of four-part proximal humerus @entity174 is carried out by choice, the results are excellent. However, when this treatment is carried out "by default" - especially because surgery is contraindicated - the results are disappointing. Level of evidence IV: prospective and retrospective studies.

Non-operative treatment of four-part XXXX of the proximal end of the humerus: results of a prospective and retrospective multicentric study.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity12432 :: ('10836', 'Species') :: ['SSV'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture'] @entity306 :: ('MESH:D002547', 'Disease') :: ['little']
@entity174 :: (MESH:D050723,Disease) :: ['fractures']
