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