PRECON TOURED PLATE OSTEOSYNTHESIS IN PROXIMAL HUMERUS FRACTURES IN ADULTS

Abstract

Arunim Swarup1, Kunal Vij2, Avinash Rastogi3, Abhay Shankar Dube4, Sunil Malhotra5

AIM
To evaluate the reliability and safety, functional outcome & complication associated with proximal humerus locking plate in treatment of proximal humerus fracture in adult and old age patient.
MATERIAL AND METHODS
The present study evaluates the functional outcome of 40 patients with displaced proximal humerus fracture managed with proximal humerus locking plate via deltopectoral approach in a prospective manner. All male or female patients between 18-60 years of age, with proximal humerus fractures and duration of injury less than 2 weeks, between May 2011 to May 2015 were evaluated. Patients were called for regular follow up for evaluation on the basis of constant shoulder Score (CSS) with the parameters of pain, range of motion and strength of limb.
RESULTS
The age of all patients ranged from 25-69 yrs. with mean (±SD) 49.70±12.16 yrs. Most of the patients were above 45 yrs. of age (65.0%) and mostly males (60.0%). There were 18 patients with Neer classification part 2, 18 with part 3 and 4 were with part 4. The union time for all patients ranged from 8-12 wks. with mean (±SD) 10.40±1.23 wks. Similarly, the duration of surgery of all patients ranged from 70-140 min with mean (± SD) 100.00 ± 20.84 min. No wound infections, vascular injuries, avascular necrosis, or loss of fixation ensued. Two patients with axillary nerve palsy recovered spontaneously within 3 months. 28 patients did not have treatment related complications (70.0%). However, 12 patients have treatment related complication (30.0%) with 5.0% screw perforation and 15.0% shoulder stiffness and 10 % varus mal-reduction. However, based on constant shoulder Score (CSS), at final evaluation, the functional outcome (i.e. efficacy of the treatment) of most of the patients were found to be excellent (70.0%), good (15.0%), poor (10.0%) and fair the least (5.0%).
CONCLUSION
Proximal humerus locking plate is a good modality for treatment of Neer type 2 and 3 displaced proximal humerus fractures but its application in Neers type 4 is associated with high complication rates.

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