SHORT TERM RESULTS OF PROXIMAL HUMERUS FRACTURE FIXATION WITH PROXIMAL HUMERUS LOCKING PLATE

DR. SHAILESH D. RAMAVAT; DR. SUYASH S. KOTHARI; DR.  DIXIT SAVAJIYANI

Volume : VI, Issue : IX, September - 2016

SHORT TERM RESULTS OF PROXIMAL HUMERUS FRACTURE FIXATION WITH PROXIMAL HUMERUS LOCKING PLATE

Dr. Shailesh D. Ramavat, Dr. Suyash S. Kothari, Dr. Dixit Savajiyani

Abstract :

Introduction:In recent years the incidence of proximal humeral fractures increased strongly. Proximal humeral fractures are the third most common fractures after hip and distal radius in elderly population. The optimal treatment of displaced, unstable fractures is still controversial. Few of the repeated problems associated with previous treatment options were implant failure with secondary dislocation, “impingement” and AVN. Aim and Objectives:Aimof this retrospective case–series of 25 patients with proximal humeral fractures was to assess complication, risks and functional outcome after ORIF with an angular stable plate. Material and Method: Retrospective study of 25 patient having proximal humerus fracture during period of June 2015 to May 2016 were classified according to the AO/Orthopaedic Trauma Association system by taking AP and Axial Radiograph and those fitting in neer’s7 criteria for operative management were studied. RESULTS:Mean ROM was forward flexion–1230, abduction–1100, external rotation–450.Average functional scores (minimum 12 months post–op) per AO/ASIF fracture type were 25.3 for type A, 21.4 for type B and 22.7 for type C. There was no statistically significant difference between groups. Functional score for patients over 65 years of age were significantly inferior. Complete humeral head osteonecrosis developed in 2 patients. 1 patient required revision surgery due to fixation failure, 1 had deep infection and 1 had artrhosis. CONCLUSION: Fixation with a PHLP provides “Batter fracture alignment” with Stability & good functionaloutcome. It provides a stable fixation with lesser chances of “impingement” in youngpatients with good–quality bone sufficient to permit early mobilization.Failure of the screws to maintain fixation in the elderly remainsa problem.