Various methods of surgical management and its utility in proximal humerus fractures: A prospective study of 30 cases

Abstract

Background: Treatment of fractures of proximal humerus has been a subject of much controversy and confusion with diversity of opinion regarding the management of fractures of proximal end of humerus. The aim of this study was to know the best modality of management of proximal humerus fracture in a defined patient group by reviewing the outcome, results and complications of the various operative procedures for fixation of proximal humerus fracture and their comparison in a series of thirty patients. METHODS: Over a two-year period, we treated thirty patients of two-part fractures and three-part fractures, with percutaneous pinning with K-wires, cancellous screws, buttress plate (T/Clover leaf), and LCP. All patients underwent rigorous postoperative rehabilitation under the supervision of physiotherapist and functional outcome was assessed with the use of Neer’s shoulder score. RESULTS: All fractures united within the first year and 1 patient had pin infection, 1 had loss of reduction, 3 cases malunion, 2 impingement and 1 case of AVN. The functional outcome of the assessment performed with Neer’s score 57% of the cases had excellent results, 20% satisfactory results, 16% of them had unsatisfactory results and failure was seen in 7% of the cases. CONCLUSION: ORIF in adult patients with proximal humeral fractures reduces hospital-stay thereby preventing loss of earning and in elderly patients prevents reflex sympathetic dystrophy, stiffness and shoulder hand syndrome by early mobilization without any undue risk of loss of fixation and reduction.