The use of locking plates in proximal humerus fractures-functional outcome based on age and fracture pattern

Background: Proximal humerus fractures are the most common upper extremity fractures in older patients. The aim of the present study was to evaluate the functional outcome and complications of proximal humeral locking plate used for healing proximal humerus fractures.Methods: This prospective study was conducted at the department of Orthopaedics, Sir T. Hospital, Bhavnagar, from June 2008 to March 2010, with 20 patients who suffered with complex proximal humerus fractures and underwent surgical treatment with proximal humerus locking plates. Functional outcome was assessed at the final follow up by using Constant Murley score.Results: The mean age of the patients was 52 years. Male: female ratio was 1.5: 2. The most common mode if injury is low velocity trauma i.e. fall while walking or fall in bathroom seen in 13 patients. Average time for clinical union was 60 days, while average time for radiological union is 90 days taken in the study. Postoperative complications were seen in 2 patients. Delayed complications were seen in 10 cases. No patients had shown implant related complications. At the final follow up according to Constant Murley score, 36% patients had shown excellent results, 53% patients had shown good results and poor results were seen in 11% of cases.Conclusion: Our results show that good to excellent outcome can be achieved in treating proximal humerus fractures using locking plates in elderly patients. Early mobilization of the shoulder can be achieved without compromising fracture union.

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Outcome analysis of patients with proximal humerus fractures treated with locking plates

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171578 ◽

2017 ◽

Vol 3 (3) ◽

pp. 401

Author(s):

Ritesh Kumar ◽

S. Natarajan ◽

Sanjeev Kumar ◽

R. Kalanithi

Keyword(s):

Surgical Technique ◽

Functional Outcome ◽

Proximal Humerus ◽

Constant Score ◽

High Energy ◽

Proximal Humeral Fractures ◽

Humeral Fractures ◽

Proximal Humerus Fractures ◽

Locking Plates ◽

Humerus Fractures

Background: Fracture of proximal humerus incidence has been reported to be 73 cases per 100,000 individuals per year. There are different methods of treatment of proximal humeral fractures. The aim of our study is to analyse the functional outcome of proximal humerus fractures treated with proximal humerus locking plates and to analyse the possible benefits and complications of the procedure.Methods: This is a retrospective study of 34 patients with proximal humeral fractures treated with ORIF using Proximal humeral locking plates from October 2010 to November 2012 at Saifee Hospital, Mumbai. The cases are evaluated as regards to functional outcome using constant score, fracture healing clinically, radiologically and complications if any and reason for them.Results: Our study shows that proximal humerus fractures are now increasingly seen in younger population with good bone stock following high energy trauma. In elderly it was low energy trauma. The average time of radiological fracture union in our study was 10 weeks (8-16 weeks). The mean constant score at final follow up was 66.7 (35-90). A total of 17 patients (51%) had excellent or good results, but in 9 (27%) the outcome was poor. Eight (23%) complications were noted resulting in poor functional outcome. Conclusions: Proximal humeral locking plate is a good method of osteosynthesis for complex proximal humerus fractures allowing early mobilization, good functional outcome. A reproducible standard surgical technique is absolutely necessary for improved patient outcome. Most of the complications in our study were related to the surgical technique. The precise surgical technique, stable fracture fixation and restoration of correct neck shaft angle are absolutely necessary for improved outcome.

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Factors Influencing the Varus Deformity of Humeral Head in Proximal Humerus Fractures and Its Relation to Functional Outcome

Indian Journal of Orthopaedics ◽

10.1007/s43465-020-00275-4 ◽

2021 ◽

Author(s):

H. Kantharaju ◽

Sangeet K. Gawhale ◽

G. S. Prasanna Kumar ◽

Balu Sahare ◽

Nadir Shah

Keyword(s):

Functional Outcome ◽

Humeral Head ◽

Proximal Humerus ◽

Varus Deformity ◽

Proximal Humerus Fractures ◽

Factors Influencing ◽

Humerus Fractures

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Internal Fixation of 4-Part Proximal Humerus Fractures and Fracture Dislocations Using Extended Deltoid-splitting Approach, Locking Plates, and Calcium Sulfate Graft

Techniques in Shoulder & Elbow Surgery ◽

10.1097/bte.0000000000000145 ◽

2018 ◽

Vol 19 (3) ◽

pp. 129-137

Author(s):

Hamid G. Zadeh ◽

Karthikeyan Somasundaram ◽

Victor Babu ◽

Roya Movahedi

Keyword(s):

Internal Fixation ◽

Calcium Sulfate ◽

Proximal Humerus ◽

Proximal Humerus Fractures ◽

Locking Plates ◽

Fracture Dislocations ◽

Humerus Fractures

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FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING COMPRESSION PLATE: A CROSS SECTIONAL STUDY

Journal of medical pharmaceutical and allied sciences ◽

10.22270/jmpas.v10i4.1407 ◽

2021 ◽

Vol 10 (4) ◽

pp. 3266-3269

Author(s):

Abhishek Patil

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Proximal Humerus ◽

Constant Score ◽

Locking Compression Plate ◽

Proximal Humerus Fractures ◽

Compression Plate ◽

Humerus Fractures ◽

The Mean

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.

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Treatment of proximal humerus fractures with locking plates: A systematic review

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2009.06.004 ◽

2009 ◽

Vol 18 (6) ◽

pp. 837-844 ◽

Cited By ~ 219

Author(s):

Christos Thanasas ◽

George Kontakis ◽

Antonios Angoules ◽

David Limb ◽

Peter Giannoudis

Keyword(s):

Systematic Review ◽

Proximal Humerus ◽

Proximal Humerus Fractures ◽

Locking Plates ◽

Humerus Fractures

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TREATMENT OF PROXIMAL HUMERUS FRACTURES AND OUTCOME – A PROSPECTIVE STUDY

10.36106/ijar/1402889 ◽

2021 ◽

pp. 84-87

Author(s):

S. Kishore Babu ◽

S. Rajeswara Rao ◽

Pamu.bala Avinash

Keyword(s):

Closed Reduction ◽

Evaluation Method ◽

Proximal Humerus ◽

Treatment Options ◽

Method Comparison ◽

Fracture Pattern ◽

Proximal Humerus Fractures ◽

Chi Square ◽

Study Results ◽

Humerus Fractures

BACKGROUND: Proximal humerus fractures are commonest fractures account for about 4 – 5% of the fractures.Complicated fracture pattern in proximal humerus are increasing due to increase inincidence of high velocity trauma. Because of inconsistency in fracture classication, treatment and evaluation method,comparison of these fractures are impeded. This studydetermines and compare the results of different modalities of xations in proximal humerus fractures and outcome. MATERIALS AND METHODS: This study was done from August 2018 to February 2020 in king Georgehospital,Visakhapatnam. Total 32 patients with proximal humerus fractures were operatedwith different modalities depend on fracture pattern.The results were evaluated using the Neers Shoulder Scoring System. RESULTS:The results show that most Neer's two part fracture had excellent to satisfactory results (85%). Neer's three part fracture also had 73% excellent to satisfactory results. Neer's four part fracture which went into failure. This study results were compared with other studies by using chi square test. CONCLUSION: The management modality depended on the pattern of the fracture andthequality of the bone .The patient's goals with treatment options for these displaced fractures included closed reduction and percutaneous screws xation (13% cases), closed reduction and percutaneous k- wires xation (9% cases) ,open reduction and internal xation (78 % cases).

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