A Prospective Clinical Study of Surgical Management of Proximal Humeral Fractures

Abstract

Background: Treatment of proximal humerus fractures has been the subject of much controversy and confusion. This is because of the complexity of these injuries, fracture displacements are difficult to see without careful radiographic views and associated soft tissue injuries: Our prospective study has evaluated the functional results of the methods of surgical management of displaced fractures of proximal end of humerus. Materials & Methods: 20 patients with displaced fractures of proximal humerus in adults undergone surgical management. Patients were followed from 6 weeks – 15 months on OPD basis with radiological , clinical & functional evaluation. Results: The most common type observed in our series was three part fracture accounting for 12 of 20 patients (60%). At the end of clinical and radiological union and full functional recovery the results were evaluated by Neer’s score. Of the 20 patients 3(15%) had excellent results, 9 (45%) had satisfactory results, 6 (30%) had unsatisfactory results and 1(5%) was a failure. 1 patient expired during follow up due to medical problems . Conclusions: Clinical evaluation, obtaining proper radiological views, age of the patient and activity levels holds the key for realistic approach in the management of fractures of proximal humerus. Anatomical reduction is an essential feature in these fractures. Open reduction and internal fixation with buttress plate as well as pinning has given good results.