Study of operative management for complex fracture of upper end of Humerus
Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah.
Background: Proximal humerus fractures are very common fractures occurring in the skeleton. They account for approximately 4 5% of the fracture attendance at the hospital. It is the most common fracture of shoulder girdle. It is the 3rd most common fracture in elderly. Till date various methods are used including percutaneous and open reduction & fixation according to fracture type.
Aims & Objective: To study the occurrence, mechanism of injury and displacement of various types of fractures and different modalities of the fixations in proximal humerus fractures. Come to conclusion about preferred modality of treatment of proximal humerus fractures according to the pattern of fracture.
Material and Methods: In present study 44 patients of complex fracture of proximal humerus treated with either open reduction internal fixation or percutaneous fixation from 2009 to 2012. Follow up assessment was done by Constant score.
Results: Radiological union occur at about 8 to 12 weeks. Closed reduction and percutaneous k wire or cancellous screws fixation showed excellent results in majority cases of 3 -part fracture. All 4 part fractures are treated with ORIF. Open reduction and internal fixation with locking compression plates showed good results among all implants used.
Conclusion: Principle of fixation is reconstruction of the articular surface, including the restoration of the anatomy, stable fixation, with minimal injury to the soft tissues preserving the vascular supply, should be applied. Majority of poor results are due to poor surgical techniques and lack early physiotherapy.
Key words: Complex Proximal Humerus Fracture; Locking Plate; Percutaneous Fixation; Hemiarthroplasty; Deltopectoral Approach