Functional outcome in surgically treated proximal humerus fractures with and without rotator cuff tear

Abstract

Proximal humerus fractures are the second most common type of fractures in incidence among upper extremity fractures after distal radius fractures. With the relatively recent advent of locking plate technology and advances in surgical techniques, a greater proportion of the proximal humerus fractures are being treated surgically than in the past. Rotator cuff muscles are the main stabilizer of the shoulder joint and are torn in case of proximal humerus fractures. Their simultaneous repair along with the fixation of proximal humerus overcomes the need for multiple surgeries on later date. This study was a prospective observational study with an aim to find the incidence of rotator cuff injury and the functional outcome following repair in comparison to intact cuff in patients with proximal humerus fractures. The patients were subjected to MRI shoulder to know the rotator cuff status preoperatively and findings compared intra-operatively. The subjects were divided into 2 groups based on rotator cuff status. Cuff tears were repaired simultaneously while fracture fixation. The patients were asked to maintain arm pouch for a period of 6 weeks and followed by shoulder rehabilitation exercises. The functional outcome were then assessed at 12 weeks and 24 weeks post-surgery. The functional outcome was comparatively better in subjects who had intact rotator cuff, compared to torn rotator cuff in proximal humerus fractures at both 12 and 24 weeks follow-up. Complications like stiffness and pain was more common in patients with torn rotator cuff.