Study on outcome and complications of surgical management of proximal humerus fractures using locking compression plate

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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Surgical management of proximal humerus fracture treated with locking compression plate

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20174707 ◽

2017 ◽

Vol 3 (6) ◽

pp. 1165

Author(s):

Sivakumar Arumugam ◽

Venkateshwara Arumugam ◽

V. Raviraman

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Proximal Humerus ◽

Early Mobilization ◽

Open Reduction Internal Fixation ◽

Locking Compression Plate ◽

Proximal Humerus Fractures ◽

Compression Plate ◽

Comminuted Fractures ◽

Humerus Fractures

Background: Proximal humerus fractures accounts for about 4 to 5% of all fractures. Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remain challenging. Significant controversy continues regarding the best methods of treating displaced proximal humerus fractures. Various operative procedures are carried out, the recent trend in internal fixation has moved on to locking plates. The present study is undertaken to evaluate the functional outcome and complication of proximal humerus fractures treated by locking compression plate.Methods: This is a prospective study comprising of 30 patients with fractures of proximal humerus were treated by open reduction and internal fixation with locking compression plate were evaluated at Velammal Institute Of Medical Sciences, Madurai from the period of April 2015 to December 2016. Clinical and radiological evaluation was done. Patients will undergo open reduction internal fixation with locking compression plate for the sustained fracture under general anesthesia.Results: In our series, the majority of the patients were males, elderly aged, with RTA being the commonest mode of injury, involving 2 part, 3 part and 4 part fractures of the proximal humerus. Excellent and satisfactory results were found in 76.7% of patients with unsatisfactory results in 23.3 % according to Neer’s criteria. There were 100 % union rates and no failures.Conclusions: In conclusion locking Compression, the plate is an advantageous implant in proximal humeral fractures due to angular stability, particularly in comminuted fractures and in Osteoporotic bones in elderly patients, thus allowing early mobilization.

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Functional Outcome of Locking Compression Plate in Neer's two-part, three-part, four-part Proximal Humerus Fractures

The Journal of Medical Sciences ◽

10.5005/jp-journals-10045-0024 ◽

2016 ◽

Vol 2 (1) ◽

pp. 1-8

Author(s):

KV Ramesh ◽

G Mahesh ◽

KC Kiran ◽

Roshan Kumar

Keyword(s):

Functional Outcome ◽

Traffic Accidents ◽

Proximal Humerus ◽

Road Traffic ◽

Early Mobilization ◽

Locking Compression Plate ◽

Proximal Humerus Fractures ◽

Compression Plate ◽

Comminuted Fractures ◽

Humerus Fractures

ABSTRACT Introduction Proximal fractures of the humerus account for about 4 to 5% of all fractures. They are the most common fractures in elderly population. Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains challenging. Objectives The present study is undertaken to evaluate the functional outcome of proximal humerus fractures treated by locking compression plate in 20 patients. Materials and methods Prospective study was done involving 20 adult patients with proximal humerus fractures admitted from October 2012 to December 2013 treated by open reduction and internal fixation (ORIF) with locking compression plate. The functional follow-up was done for a minimum period of 3 months and the patients were evaluated by Constant Murley scoring (CMS). Results In our series, the majority of the patients were middle-aged males, with road traffic accidents (RTAs) being the most common cause of injury, involving 2-part, 3-part, and 4-part fractures of the proximal humerus. The fractures were united in 19 patients and 1 patient had avascular necrosis (AVN). Excellent results were seen in 15% of patients, good results in 55%, moderate results in 15%, and poor results in 15% according to CMS. There were 95% union rates, 5% of AVN, and no failures. Conclusion In conclusion, locking compression plate is an advantageous implant in proximal humerus fractures due to angular stability, particularly in comminuted fractures and in osteoporotic bones of elderly patients, which allows their early mobilization. How to cite this article Mahesh G, Kiran KC, Ramesh KV, Kumar R. Functional Outcome of Locking Compression Plate in Neer's two-part, three-part, four-part Proximal Humerus Fractures. J Med Sci 2016;2(1):1-8.

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Minimally invasive plate osteosynthesis with a locking compression plate is superior to open reduction and internal fixation in the management of the proximal humerus fractures

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-15-206 ◽

2014 ◽

Vol 15 (1) ◽

Cited By ~ 27

Author(s):

Tao Lin ◽

Baojun Xiao ◽

Xiucai Ma ◽

Dehao Fu ◽

Shuhua Yang

Keyword(s):

Minimally Invasive ◽

Internal Fixation ◽

Open Reduction ◽

Proximal Humerus ◽

Plate Osteosynthesis ◽

Locking Compression Plate ◽

Minimally Invasive Plate Osteosynthesis ◽

Proximal Humerus Fractures ◽

Compression Plate ◽

Humerus Fractures

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Outcomes for four-part proximal humerus fractures treated with a locking compression plate and an autologous iliac bone impaction graft

Injury ◽

10.1016/j.injury.2012.06.029 ◽

2012 ◽

Vol 43 (10) ◽

pp. 1724-1731 ◽

Cited By ~ 25

Author(s):

Sae Hoon Kim ◽

Young Ho Lee ◽

Seok Won Chung ◽

Seung Han Shin ◽

Woo Young Jang ◽

...

Keyword(s):

Proximal Humerus ◽

Locking Compression Plate ◽

Iliac Bone ◽

Proximal Humerus Fractures ◽

Compression Plate ◽

Humerus Fractures

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Assessment of Functional and Radiological Outcome in Patients of Proximal Humerus Fractures Managed by Proximal Humerus Locking Compression Plate - A Longitudinal Observational Study from Moradabad, Uttar Pradesh

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/267 ◽

2021 ◽

Vol 8 (19) ◽

pp. 1403-1408

Author(s):

Amit Saraf ◽

Ashish Maurya ◽

Ajay Pant

Keyword(s):

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Locking Compression Plate ◽

Humerus Fracture ◽

Proximal Humerus Fractures ◽

Radiological Outcome ◽

X Ray ◽

Longitudinal Observational Study ◽

Compression Plate ◽

Humerus Fractures

BACKGROUND The proximal humerus fractures are mostly undisplaced fractures. Various complications which were encountered with the closed treatment included: subacromial impingement, malunion, shoulder pain, avascular necrosis, stiffness secondary to osteoarthritis and the rotator cuff deficiency. In order to overcome these complications, trend has shifted towards surgical management. The present study was conducted to assess the functional and radiological outcome in patients with proximal humerus fracture managed by proximal humerus locking compression plate. METHODS This was a longitudinal observational study (combination of retrospective and prospective design) conducted in the Department of Orthopaedics in Teerthanker Mahaveer Medical College and Research Centre, Moradabad. All patients with proximal humerus fractures under Neer’s classification who fulfilled our inclusion criteria were included. The radiological assessment was done by union, complication or any failure on x-ray and functional outcome was assessed by University of California at Los Angeles (UCLA) score. Surgery was performed under general/brachial anaesthesia in beach chair position. Delto-pectoral approach was used. Injectable antibiotics (3 rd generation cephalosporin) and analgesic (paracetamol/tramadol) were given for 3 days after surgery. Post op. X- ray of shoulder with arm antero-posterior and lateral view were taken on 2nd day of surgery RESULTS A total of 34 patients were included in the study who were followed up for a minimum of one year. At the end of the follow up, 25 patients showed union except for 3 non-union, 1 delayed union, 2 valgus and 2 varus deformity, 2 avascular necrosis (AVN) and 2 infections. The functional outcomes were excellent in 5 patients, good in 14 patients, fair in 9 patients and poor in 6 patients. CONCLUSIONS Proximal humerus locking compression plate is a safe and effective procedure for the management of proximal humerus fracture for young as well as older age group individuals with good functional outcome. The complications are acceptable and can occur in any hospital with any experienced surgeon. KEYWORDS Proximal Humerus, Fracture, Compression Plate

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