Evaluation of Different Modalities of Osteosynthesis of Proximal Humerus Fractures in Adults

Abstract

Background: Proximal humerus fractures account for approximately 4-5% of the fracture attendance at the hospital. The management of proximal humeral fractures has always been an enigma because of numerous muscles attachment and paucity of space for fixing the implant. The objective of the present study was to compare different modalities of fixation in proximal humerus fractures. Methods: This is a retrospective study done on 112 patients of acute proximal humerus fractures treated surgically. Follow up was done for 12 months and results were analyzed using Neer’s scoring system. Results: Radiological union occurred at average time of 10.1 weeks. As per Neer's scoring system, 36% patients had excellent results while 31% patients had satisfactory results. They were all pain free and successfully returned to their pre-injury work. 25% patients had unsatisfactory and 8% failure result. 2 patients required revision surgery. Conclusion: Treatment options depend on fracture pattern, bone quality, patient's goals and surgeon’s familiarity with the technique. Patients who have two part greater tuberosity avulsion fracture are best treated by closed reduction and percutaneous screws fixation. Patients who have metaphyseal comminution and/or three-part fracture with appreciable displacement of the greater tuberosity are more appropriately treated by open reduction and Internal fixation with a plate. Key Words: Osteosynthesis, Proximal humerus fractures, Internal fixation