CLINICAL STUDY OF FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF PROXIMAL HUMERUS FRACTURE

Dr K.Vijay Mohan Reddy; Dr C.Venkappa; Dr Chandan S; Dr. K.Suman Kumar; Dr. K.Laalasa

Volume : X, Issue : VI, June - 2020

CLINICAL STUDY OF FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF PROXIMAL HUMERUS FRACTURE

Dr K. Vijay Mohan Reddy, Dr C. Venkappa, Dr Chandan S, Dr. K. Suman Kumar, Dr. K. Laalasa

Abstract :

BACKGROUND: Fractures of the proximal humerus are complex injuries with significant morbidity. Although various options of management available including non– operative management are present the choice of treatment depends upon the pattern of the fracture, the quality of the bone encountered, the patient‘s goals 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 18 months period we treated twenty patients with failed conservative treatment of two part fractures, three part fractures, four part fractures and fracture dislocations. Initial pre operative clinical and radiological assessment was done and appropriate mode of treatment of given depending upon type of fracture according Neer’s classification. Follow up of patient was done both clinically and radiologically at 2nd, 6th and 8th weeks and assessed for any complications. Final assessment was done according to Neer’s shoulder scoring criteria. RESULTS: Eight patients were treated with Locking Compression Plate, eight patients were treated with K–wires and cancellous screws, three patient 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: There is direct relationship in displaced proximal humeral fractures 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 of humerus produced good functional outcome and fewer complications. Rehabilitation is the key to success.