Volume : IV, Issue : VIII, August - 2014

Percutaneous Fixation of Proximal Humerus Fractures With External Fixator in High Risk Patients

Dr. N. M. Bhavsar, Dr. P. N. Patel, Dr. S. J. Patel, Dr. N. P. Parikh, Dr. P. R. Patel, Dr. N. A. Lil

Abstract :

The incident of the proximal humerus fractures in on the rise in the last decade. Many treatment options are available like conservative treatment, open reduction internal fixation, joint replacement, and percutaneous fixation. ).ORIF is associated with surgical trauma, higher rates of infection, avascular necrosis of the humeral head, and neurovascular lesions. Therefore the trend has changed in a past few years from massive internal fixation to closed reduction and minimal fixation. The advantages of the percutaneous pinning are not only the possibility of preservation of the blood supply to bone fragments, no blood loss and the possibility of surgery under achial block. The latter prerogatives may be of considerable importance when treating patients in poor general condition, such as those in American Society of Anesthesiologists(ASA) physical status (PS) three or four. Adding an external fixation to this minimizes the complications of pinning. Between 2010 and 2012 ASA PS three or four assigned to 35 patients admitted at our hospital with proximal humerus fracture. Patients were classified according to NEER’s classification were taken for closed reduction and percutaneous pinning. Thirty (17 female and 13 male) out of these 35 were available for evaluation both radiologically and clinically with an average follow up of 8 months ( range from 6 months to 1 year). Five patients were not included in the study as they were lost to follow up. The average age of the patients was 66.56(range 52 to 87). There were 3 with two part, 26 with three part and 1 with four part. Twelve patients (40%) had excellent results, fourteen (46%) had good, two (6.66%) had fair and two (6.66%) had poor results. The average constant score was 84.26(range 39 to 96).The average age of the patient with two part fracture was 61 years compared with 67 years for three part fractures. The two–part fractures had better results than the three part fractures, with an average Constant score, adjusted for age and gender, of 91(range 87–95) and 83.86(range39– 96) respectively. Percutaneous pinning is a good treatment option in high operative risk patients and adding an external fixation to that helps in maintaining valgus of the head of humerus, it minimizes the complications of percutaneous pinning even in osteoporotic patients.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Dr. N.M.Bhavsar, Dr. P.N.Patel, Dr. S.J. Patel, Dr. N.P. Parikh, Dr. P.R. Patel, Dr. N.A. Lil Percutaneous Fixation of Proximal Humerus Fractures With External Fixator in High Risk Patients Indian Journal of Applied Research, Vol.4, Issue.8 August 2014

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