Amit Saraf1, Ashish Maurya2, Ajay Pant3
BACKGROUND
The proximal humerus fractures are mostly undisplaced fractures. Various
complications which were encountered with the closed treatment included: subacromial
impingement, malunion, shoulder pain, avascular necrosis, stiffness
secondary to osteoarthritis and the rotator cuff deficiency. In order to overcome
these complications, trend has shifted towards surgical management. The present
study was conducted to assess the functional and radiological outcome in patients
with proximal humerus fracture managed by proximal humerus locking
compression plate.
METHODS
This was a longitudinal observational study (combination of retrospective and
prospective design) conducted in the Department of Orthopaedics in Teerthanker
Mahaveer Medical College and Research Centre, Moradabad. All patients with
proximal humerus fractures under Neer’s classification who fulfilled our inclusion
criteria were included. The radiological assessment was done by union,
complication or any failure on x-ray and functional outcome was assessed by
University of California at Los Angeles (UCLA) score. Surgery was performed under
general/brachial anaesthesia in beach chair position. Delto-pectoral approach was
used. Injectable antibiotics (3rd generation cephalosporin) and analgesic
(paracetamol/tramadol) were given for 3 days after surgery. Post op. X- ray of
shoulder with arm antero-posterior and lateral view were taken on 2nd day of
surgery.
RESULTS
A total of 34 patients were included in the study who were followed up for a
minimum of one year. At the end of the follow up, 25 patients showed union
except for 3 non-union, 1 delayed union, 2 valgus and 2 varus deformity, 2
avascular necrosis (AVN) and 2 infections. The functional outcomes were excellent
in 5 patients, good in 14 patients, fair in 9 patients and poor in 6 patients.
CONCLUSIONS
Proximal humerus locking compression plate is a safe and effective procedure for
the management of proximal humerus fracture for young as well as older age
group individuals with good functional outcome. The complications are acceptable
and can occur in any hospital with any experienced surgeon.
