scholarly journals Clinico-radiological and functional outcome of Neer’s 2 part, 3 part and 4 part proximal humeral fractures in elderly treated by conservative management in a tertiary care centre of North India

2021 ◽  
Author(s):  
Pankaj Spolia ◽  
Abdul Ghani
Keyword(s):  
Elderly Patients ◽  
Prospective Study ◽  
Functional Outcome ◽  
Constant Score ◽  
Tertiary Care ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
North India ◽  
Excellent Outcome

<p><strong>Background:</strong> Treatment of proximal humeral fractures is challenging. Despite a rising incidence in proximal humeral fractures, there is still no evidence for the best treatment option, especially for the elderly patients. The aim of this prospective study was to evaluate the radiological in terms of union and functional outcome in terms of pain, range of motion of conservatively managed proximal humeral fractures in elderly patients.</p><p><strong>Methods:</strong> This was an observational prospective study of 35 patients aged above 65 years with proximal humeral fractures including 2 part, 3 part and 4 part based on Neer’s classification, treated by conservative method. Functional outcome was assessed by using Constant score at follow up of 1 year.</p><p><strong>Results: </strong>Out of 35 patients, 21(60%) were female and 14 (40%) were male with mean age of 76.8 (range 65 to 91years). On the basis of Neer’s classification, majority of patients (15, 42.8%) had 3 part fracture. Radiological union was achieved within 13 to 24 weeks, with an average of 18.4 weeks. Out of 35, 5 (14.3%) had<strong> </strong>excellent outcome, 8 (22.8%) had good functional outcome, 16 (45.7%) had moderate outcome, 6 (17.14%) had poor outcome. The results were comparable with the existing literature.</p><p><strong>Conclusion: </strong>In the present study, our data shows that the proximal humeral fractures can be effectively managed conservatively in the elderly patients. Two part fractures have best functional outcome and four part fractures have highest rate of complications.</p>

scholarly journals Clinico-radiological and functional outcome of surgical management of displaced two part, three part and four part proximal humeral fractures in adults treated by PHILOS plate in a tertiary care hospital in North India: a prospective study of 30 patients

2021 ◽  
Vol 9 (10) ◽  
pp. 3006
Author(s):  
Pankaj Spolia ◽  
Abdul Ghani ◽  
Sakib Arfee
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Rigid Fixation ◽  
Care Hospital ◽  
Excellent Outcome ◽  
Good Functional Outcome ◽  
Philos Plate

Background: Treatment of proximal humeral fractures is challenging. In the past, the fractures were treated conservatively which compromised the functional results. PHILOS plate provides a good functional outcome with context to the early joint mobilization and rigid fixation of the fracture.Methods: This was the prospective study of 30 patients aged 20 to 60 years (mean age 48.4 years) with proximal humeral fractures including two part, three part and four part fractures based on Neer’s classification, treated by open reduction internal fixation with PHILOS plating. Functional outcome was assessed using Constant-Murley Score.Results: The final outcome was observed at 6 months follow up. The results were comparable with the existing literature. The Mean Constant Score at 6 month follow up was 79.4, range (38 to 92). Out of 30, (n = 12, 40%) had excellent outcome, (n = 9, 30%) had good functional outcome, 6 (20%) had moderate outcome, 3 (10 %) had poor outcome. Out of 30 patients, one patient with four part fracture had a lowest CS of 38. Complications were observed in 5, (16.7%) patients. Varus malunion in one patient, avascular necrosis in one patient, stiffness in one patient.Conclusions: PHILOS plate gives stable fixation, enables early range of motion and minimizes complications with good functional outcome if done with expert hands.

Functional outcome following one-part proximal humeral fractures: A prospective study

2008 ◽  
Vol 17 (2) ◽  
pp. 216-219 ◽  
Author(s):  
Nirmal C. Tejwani ◽  
Frank Liporace ◽  
Michael Walsh ◽  
Monet A. France ◽  
Joseph D. Zuckerman ◽  
...  
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
A Prospective Study

scholarly journals Primary Hemiarthroplasty for Proximal Humeral Fractures in the Elderly: Long-Term Functional Outcome and Social Implications

2007 ◽  
Vol 33 (5) ◽  
pp. 512-519 ◽  
Author(s):  
Michael Dietrich ◽  
Christoph Meier ◽  
Daniela Zeller ◽  
Patrick Grueninger ◽  
Roger Berbig ◽  
...  
Keyword(s):  
Functional Outcome ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Social Implications

scholarly journals Use of proximal humerus internal locking system plate in proximal humerus fractures and its relation with the functional outcome

2019 ◽  
Vol 6 (1) ◽  
pp. 90
Author(s):  
Prasanna Kumar G. S. ◽  
Akash V. Mane ◽  
Amit Kumar Yadav ◽  
Abhishek Harsoor ◽  
Jithsen Manna
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Proximal Humerus ◽  
Constant Score ◽  
Tertiary Care ◽  
Care Hospital ◽  
Proximal Humerus Fractures ◽  
Excellent Outcome ◽  
Good Outcome ◽  
Humerus Fractures

<p class="abstract"><strong>Background:</strong> Proximal humerus fractures are the fractures occurs at or proximal to the surgical neck of the humerus, which accounts for 7% of all fractures and 80% of all humeral fractures. Now a days most of these fractures are managed with internal fixation because of better availability of anatomical plates. The aim was to assess the functional outcome and complications of proximal humerus fractures treated with proximal humerus internal locking system (PHILOS).</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 30 patients with two, three, and four parts proximal humerus fractures treated with proximal humerus internal locking sysyem from 2016 to 2018 with 25 to 80 years of age in a tertiary care hospital. Functional outcome is assessed by using constant murley shoulder scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> Functional outcome as per constant score, 10 patients (33%) got excellent outcome, 06 patients (20%) got very good outcome, 07 patients got (23%) good outcome, 05 patients got (17%) fair outcome and 02 patients got (07%) poor outcome. Complications observed were superficial infections, implant failure and axillary nerve neuropraxia.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation by using PHILOS is the ideal method in treating displaced proximal humerus fractures mainly in two and three part proximal humerus fractures which provides stable fixation and less complications.</p>

scholarly journals MutiLoc Nail Versus Philos Plate in Treating Proximal Humeral Fractures: A Retrospective Study Among the Alderly

2021 ◽  
Vol 12 ◽  
pp. 215145932110439
Author(s):  
Guoyun Bu ◽  
Weitang Sun ◽  
Jian’an Li ◽  
Tao Yang ◽  
Mingxin Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Operation Time ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Plate Group ◽  
Philos Plate ◽  
Fracture Types

Background Proximal humeral fractures (PHFs) account for 4–5% of all fractures in the elderly. There is still a controversy among the treatments in the displaced PHFs. Our aim was to explore the clinical outcome of PHFs with the treatment of MultiLoc nail or Philos plate in the elderly patients. Methods A total of 82 sustained elderly patients with PHFs were finally recruited between Dec 2016 and Dec 2017. 34 patients were treated with MultiLoc nail and 48 patients were treated with Philos plate. The demographics, fracture types, blood loss, operation time, union time, postoperative complications, visual analog scores (VASs), Constant scores, American Shoulder and Elbow Scores (ASESs), and neck-shaft-angle (NSA) between the two groups were compared. Results No differences were observed in the demographics, fracture types, VAS, Constant scores, and ASES scores between the two groups at final follow-up. Compared with the plate group, the blood loss, operation time, and union time were significantly lower in the nail group (all P < .05). The rate of general complications was 54.17% in the plate group, which was higher than that in the nail group (26.47%, P = .01). Three patients experienced reoperation in the plate group (3/48; 6.25%), but none in the nail group. Although there were no significant differences in intraoperative NSA between the two groups, the NSA at final follow-up in the nail group was much higher than the plate group (137.55 ± 5.53°vs 134.47 ± 5.92°, P = .02). Conclusions Multiloc intramedullary nail showed the similar effectiveness of final VAS, final Constant scores, and ASES scores in PHFs treatment with Philos plate. However, MultiLoc nail is superior to Philos plate in blood loss, operation time, complications, reoperation rate, and the change of NSA.

scholarly journals Radiological correlation with functional outcome in displaced proximal humerus fractures treated with locking plates: a prospective study of 35 cases

2018 ◽  
Vol 4 (3) ◽  
pp. 471
Author(s):  
Neetin Pralhad Mahajan ◽  
Nikhil Dilip Palange ◽  
Eknath D. Pawar ◽  
Hitesh Jivrajbhai Mangukiya ◽  
Ujwal Suryabhan Ramteke ◽  
...  
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Proximal Humerus ◽  
External Rotation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plates ◽  
Range Of Movement ◽  
Maximum Improvement

<p class="abstract"><strong>Background:</strong> The objective of this prospective study is to investigate the relationship between the functional outcome and the radiographic results of two-, three- and four part proximal humeral fractures treated with open reduction and fixation with PHILOS locking plate.</p><p class="abstract"><strong>Methods:</strong> 35 patients (30 males and 5 females) with displaced proximal humerus fracture were treated with PHILOS plating and studied prospectively. According to Neer’s classification there were 16 two part fracture (45%), 15 three part fracture (42%) and 4 four part fracture (13%). The healing of fracture, head shaft angle (HSA) and complications were evaluated radiologically with plain radiographs whereas the functional outcome was assessed by the Shoulder Pain and Disability Index (SPADI) at 6 weeks, 3 months, 6 months and 1 year after surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, patients treated with locking plates had mean forward flexion of 123°, abduction of 124°, mean external rotation of 30° and internal rotation 53° at 1 year follow-up. Maximum improvement in range of movement occurred between interval of 12 weeks to 24 weeks due to complete fracture union occurred approximately up to 12 weeks. The mean SPADI score at end of 1 year were 10.22, 10.38 and 10.20 for two, three and four part fractures respectively. Average postoperative and follow-up HSA's were 134.1±4.4 and 132.5±1.2 degrees, respectively. Varus progression was more prominent in patients with postoperative HSA &lt;130 (p&lt;0.001). Complications included impingement in 1 case, joint penetration by screw in 1 case, failure of fixation in 1 case and infection in 1 case.</p><p class="abstract"><strong>Conclusions:</strong> Fixed angle locked plate is an extremely useful implant for reconstruction and salvage of proximal humeral fractures. Precise surgical technique, stable fracture fixation and restoration of anatomical reduction are absolutely necessary for improved outcome.</p>

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