Study of Functional Outcome of Surgical Management of Proximal Humerus Fractures in a Tertiary Care Hospital


Authors : Dr. D. LAKSHMI KANTH; Dr. C. SIVA KUMAR

Volume/Issue : Volume 8 - 2023, Issue 2 - February

Google Scholar : https://bit.ly/3IIfn9N

Scribd : https://bit.ly/3meAVp1

DOI : https://doi.org/10.5281/zenodo.7688681

Fractures of the proximal humerus are complex injuries with significant morbidity. Although variousoptions of management available including non-operative management are present the choice of treatment depends uponthe fracture pattern, the bone quality of the proximal humerus, the patient's needs after treatment and the surgeon's familiarity with the techniques. The aim of this study was to review the functional, radiographic results and complications of the operative procedure in a series of twenty patients. METHODS: Over a period of 18 months, we treated twenty patients with failed conservative treatment of two part fractures, three part fractures, four part fractures and fracture dislocations. Initial pre operative workup was done including clinical examination and radiological assessment and appropriate treatment is selected depending upon fracture type according to Neer's classification. Patient was followed up both clinically and radiologically at 2nd, 6th and 8thweek and assessed for occurance of any complications. Neer's shoulder scoring criteria was used to do the final assessment. RESULTS: Eight patients were treated with Locking Compression Plate (LCP), K-wires and cancellous screws were used in 8 patients, three patients were treated by interlocking nail, remaining one underwent hemi-arthroplasty. All fractures united with average of 17.7 weeks. In the overall results analyzed in our series, 70% of the patients had excellent and satisfactory results and 30% had unsatisfactory and failure outcome. CONCLUSION: In displaced proximal humerus fractures, direct relationshipwas noted between fracture severity i.e. displacement and comminution, and the eventual results. That is more the initial insult, worse the prognosis. Internal fixation of fractures of proximal end ofhumerus produced good functional outcome and fewer complications. Rehabilitation is the key to success

Keywords : Proximal end of humerus, internal fixation, rehabilitation, Neer's shoulder score.

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