ResumoObjetivo Avaliar os resultados dos pacientes com fraturas epifisárias tratados com redu??o e osteossíntese. Método Entre outubro de 1996 e dezembro de 2009 foram operados 53 ombros (52 pacientes) com fraturas epifisárias. Foram excluídos os pacientes tratados com artroplastia primária e/ou que tinham seguimento inferior a dois anos. Foram reavaliados 34 ombros de 34 pacientes, 23 do sexo masculino, com média de 47 anos. A avalia??o foi feita com a escala da UCLA. Resultados O tempo de seguimento pós‐operatório médio foi de 50 meses. Doze pacientes evoluíram com resultados excelentes, sete bons, cinco regulares e dez maus (55,8% de resultados satisfatórios e 44,2% de insatisfatórios). O escore {UCLA} teve média de 26 pontos. As médias de mobilidade pós‐operatória foram de 117° de eleva??o, 36° de {RL} e {L1} de RM. No {RX} pós‐operatório imediato, verificamos a redu??o anat?mica em 17 pacientes (50%). A necrose foi constatada em 18 pacientes, seis grau {II} e 12 grau III. Sexo feminino e fraturas reduzidas anatomicamente foram estatisticamente melhores na escala da {UCLA} (p = 0,01 e p = 0,0001 respectivamente). Conclus?es O sexo feminino teve um valor médio do {UCLA} superior ao sexo masculino (p = 0,01). As fraturas reduzidas anatomicamente obtiveram {UCLA} superior (p = 0,0001) e um menor índice de necrose (p = 0,0001). A reconstru??o das fraturas epifisárias levou a resultados satisfatórios em 55,8%, deve ser indicada para pacientes jovens e ativos. Abstract Objective This study aimed to assess the outcomes of patients with humeral head fractures treated by reduction and osteosynthesis. Method A total of 53 shoulders (52 patients) with humeral head fractures were operated between October 1996 and December 2009. Patients previously treated with primary arthroplasty and/or those who had less than two years follow‐up were excluded. A total of 34 shoulders of 34 patients were therefore reassessed. In the sample studied, 23 patients were male and mean age was 47 years. Cases were assessed based on the {UCLA} score. Results Mean post‐operative follow‐up was 50 months. Twelve patients evolved with excellent outcome, seven good, five regular, and ten with poor outcome (55.8% satisfactory and 44.2% unsatisfactory outcomes). Mean {UCLA} score was 26 points. Mean post‐operative range of motion measurements were 117° elevation, 36° {LR} and {L1} MR. At the immediate post‐operative radiography, anatomic reduction was evident in 17 patients (50%). Necrosis was detected in 18 patients, six Grade {II} and 12 Grade {III} cases. Female gender and anatomically reduced fractures were statistically better at {UCLA} scale (p = 0.01 and p = 0.0001 respectively). Conclusions Female patients had a higher mean {UCLA} score than male patients (p = 0.01). Anatomically reduced fractures had higher {UCLA} scores (p = 0.0001) and lower necrosis rate (p = 0.0001). Reconstruction of humeral head fractures had a satisfactory outcome in 55.8% of cases and should be indicated in young and active patients.
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