INTRODUCTIONFractures of the proximal humerus represent approximately 4% of all fractures and 26% of humerus fractures.1 These are the second most common upperextremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age. The risk factors for proximal humeral fractures are primarily associated with low bone mineral density and an increased risk of falls. The most common mechanism of injury in proximal humeral fractures in elderly patients is a fall from standing height onto an outstretched upper extremity. In patients aged less than 50 years, the mechanism is often related to high-energy trauma, such as significant falls from height, motor vehicle accidents, or athletic injuries.The injury is of great importance when it affects the young and middle age groups of the population. It leads to temporary disability and loss of working hours. ABSTRACT Background:Fractures of the proximal humerus are the second most common upper extremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age. Methods: The study was conducted in patients treated for displaced proximal humerus fracture at Adichunchanagiri Institute Of Medical Sciences, BG Nagar from the month of June 2014 to August 2016. Twenty proximal humerus fracture patients were taken into the study; all were fixed with PHILOS plate. Patients' age ranged from 18 to 75 years with a mean of 42.9. Results: The sample consisted of twenty patients of proximal humeral fractures. 08 were males and 12 females. The patients' ages ranged from 18-75 years with a mean age of 42.9 years. The causes of fractures were road traffic accident in 13 patients, fall in 06 patients and electric shock in 1 patient. 11 fractures involved the right side and 09 involved the left. Patients were followed up from 03 weeks to 06 months. Functional outcome was rated as per Constant-Murley Shoulder Score, we got excellent results in 04 cases, satisfactory in 10, unsatisfactory in 05 xi and failure in 01 patient. Mean Constant-Murley score of this study at the end of the final follow-up period was 81.6. Conclusions: The PHILOS plate is a good implant to use for fractures of the proximal humerus. However, proper placement of the plate and fixation are required to produce satisfactory results. We recommend use of this implant in Neer 2-part, 3-part, 4-part fractures with or without dislocation and osteoporotic fractures.

No abstract

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor.

INTRODUCTIONFractures of the humeral shaft account for roughly 3% to 5% of all fractures. The predominant causes of humeral shaft fractures include simple falls or rotational injuries in the older population and higher energy mechanisms in the younger patients including motor vehicle accidents, assaults, fall from height and throwing injuries. Road traffic accidents was the commonest mode of injury in most of the studies accounting to about 70% and the mid ABSTRACT Background: Fractures of the humeral shaft account for roughly 3% to 5% of all fractures. The predominant causes of humeral shaft fractures include simple falls or rotational injuries in the older population and higher energy mechanisms in the younger patients including motor vehicle accidents, assaults, fall from height and throwing injuries. Treatment options for humeral fractures vary according to the type of fracture, age group, bone density, soft tissue status and associated complications. Surgical management of shaft humerus fractures by plating can be done mainly through Thompson's (posterior) approach and Henry's (antero-lateral) approach. Methods: The study was conducted in patients treated for shaft humerus fracture at Adhichunchanagiri Institute of Medical Science, BG Nagara from the month of August 2014 to January 2016. Twenty patients diagnosed as shaft humerus fracture were taken into the study, all were undergone open reduction and internal fixation using dynamic compression plate in Thompson's and Henry approach. Patients' age more than 18 years were taken up for the study. Patients were followed up at 3 weeks, 6 weeks, 6 months. Results: The sample consisted of twenty shaft humerus fracture patients with 10 males and 10 females. The patients' ages were more than 18 years where 13 cases (65%) between 26 to 55 years. Among these 20 patients, 10 involved the right side and 10 involved the left side. All patients achieved clinical and radiological union at 6 month follow up. According to Constant Murley Score, excellent result were found in 11 patients (55%), good in 2 patients (10%) and fair in 7 patients (35%). According to Mayo elbow performance index, 17 patients showed excellent outcome (85%) and 3 patients showed good outcome (15%). Conclusions: Dynamic compression plating is the best modality of management for the internal fixation of humeral shaft fractures. It is found that the fracture fixation of upper and middle one-third humerus in Henry's approach is easier, lower one-third humeral fractures are not possible because the plate at the supracondylar ridge poses difficulty to fix. Fracture fixation of the lower one third and middle one third is easier in Thompson's approach because of the flat surface of the bone and offers better plate contour.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Among all the fractures in upper limb in children, supracondylar fractures of the humerus are more common injuries. In general the fractures of children are treated conservatively. But the management of supracondylar fractures has evolved over years from conservative to more aggressive approach operative techniques.</span></p><p class="abstract"><strong>Methods:</strong> The study was conducted in children's presenting with type 3 Gartland supracondylar fractures to Adichunchanagiri Institute of Medical Sciences, B. G. Nagara between January 2014 to December 2016.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study consisted of 40 type 3 supracondylar fractures cases. Group A (closed reduction) had 25 cases, among them were 20 males and 5 were females. Group B (open reduction) had 15 cases among them 12 males and 3 female cases. The patients were between the age of 6 to12 years. In Group A, 19 children were in the age group of 6-10 years where as Group B had 12 cases. In Group A, 6 were in the age group of 10-12 years and 3 cases in Group B. Among the 25 cases in Group A, 19 were left sided and 6 were right sided. In group B, 11 were left sided and 4 were right sided. All patients had achieved clinical and radiological union at 4 weeks. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Closed reduction and k-wiring had very good results for type 3 supracondylar fractures of humerus in children than conservative/open reduction methods. However for cases which we didn't get proper/satisfactory reduction in closed method, open method with triceps splitting approach was used.</span></p>