Rationale and Results of Proximal Humerus Fracture Fixation

Abstract

AIM Now a day it becomes a challenge in treating proximal humerus fractures and as we know the commonest problem is shoulder stiffness. The aim was to analyse the rational and results of proximal humerus fracture fixation by various methods. MATERIAL AND METHODSWe operated on 36 patients from 2010-2016. The common age group affected was 51-60 years. Most of the injuries were caused by domestic accidents. Neer system was used for classification. Majority of the fractures were treated with closed reduction and percutaneous fixation. Failure to reduce the fracture by closed manipulation meant we ended up with open reduction and fixation with K-wire /screw/osseous sutures. RESULTSThe mean follow-up was 3.8 years. All fractures healed. Malunion occurred in six patients. Superficial pin tract infection, pin migration, pins loosening and avascular necrosis found only in few and that did not affect the final outcome. The functional results were analysed using Constant-Murley score. Four patients had moderate pain. Two patients had shoulder stiffness. The mean final constant score was 83 points or 89.65% of opposite normal shoulder. There is no statistically significant difference in Constant score found between different types of fractures. DISCUSSION AND CONCLUSIONSurgical fixation of the proximal humerus fractures gives good results with least stiffness and pain free joint. This was possible because of achieving anatomical realignment and early mobilisation after stable fixation by various methods depending on the type and personality of the fracture. KEYWORDSProximal Humerus, Neer, Minimal Fixation HOW TO CITE THIS ARTICLE: Kannan K, Palaniappan M, Anbu S, et al. Rationale and results of proximal humerus fracture fixation.