scholarly journals Functional Outcome of Proximal Humerus Fracture Managed Surgically by Joshi's External Stabilizing System

2021 ◽  
Vol 9 (02) ◽  
pp. 8-13
Author(s):  
Prakriti Raj Kandel ◽  
Bipan Shrestha ◽  
Kishor Man Shrestha ◽  
Shreshal Shrestha ◽  
Pradip Chhetri
Keyword(s):  
Functional Outcome ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Treatment Options ◽  
Humerus Fracture ◽  
Medical Sciences ◽  
Shoulder Stiffness ◽  
Significant Difference ◽  
Type Of Fracture ◽  
The Ideal

INTRODUCTION: The ideal management of proximal humerus fracture is still controversial despite various treatment options. Conservative treatment with slab is fraught with shoulder stiffness and malunion while surgical treatment with plates and nail is fraught with infection and blood loss. Therefore, Joshi External Stabilization System (JESS) being a minimally invasive percutaneous procedure can be the ideal treatment for these fractures. MATERIAL AND METHODS: This prospective and observational hospital based study was carried out in Orthopedics Department, Universal College of Medical Sciences Teaching Hospital (UCMS-TH) from December 2018 to January 2021. All patients with traumatic proximal humerus fracture who fulfilled the inclusion criteria were enrolled in the study and were treated with JESS. Fracture was classified according to Neer classification and functional outcome was assessed according to Constant Murley Score (CMS) system. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months. RESULTS: There was statistically significant difference in VAS score (p<0.05) measured at six weeks, three months and six months; and CMS (p<0.05) at three months and six months. There was statistically significant difference between fracture type (Neer type) and fracture union (p<0.05). But the association between functional outcome and type of fracture was statically insignificant (p>0.05). CONCLUSION: Displaced proximal humerus fracture when treated surgically with JESS has good functional and radiological outcome. It produces less pain, less stiffness and greater Range of Motion (ROM).

scholarly journals How Many Proximal Screws Are Needed for a Stable Proximal Humerus Fracture Fixation?

2021 ◽  
Vol 12 ◽  
pp. 215145932199274
Author(s):  
Hyojune Kim ◽  
Myung Jin Shin ◽  
Erica Kholinne ◽  
Janghyeon Seo ◽  
Duckwoo Ahn ◽  
...  
Keyword(s):  
Cyclic Loading ◽  
Proximal Humerus Fracture ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Proximal Fragment ◽  
Maximum Displacement ◽  
Significant Difference ◽  
Load To Failure ◽  
Screw Group

Purpose: This biomechanical study investigates the optimal number of proximal screws for stable fixation of a 2-part proximal humerus fracture model with a locking plate. Methods: Twenty-four proximal humerus fracture models were included in the study. An unstable 2-part fracture was created and fixed by a locking plate. Cyclic loading and load-to-failure tests were used for the following 4 groups based on the number of screws used: 4-screw, 6-screw, 7-screw, and 9-screw groups. Interfragmentary gaps were measured following cyclic loading and compared. Consequently, the load to failure, maximum displacement, stiffness, and mode of failure at failure point were compared. Results: The interfragmentary gaps for the 4-screw, 6-screw, 7-screw, and 9-screw groups were significantly reduced by 0.24 ± 0.09 mm, 0.08 ± 0.06 mm, 0.05 ± 0.01 mm, and 0.03 ± 0.01 mm following 1000 cyclic loading, respectively. The loads to failure were significantly different between the groups with the 7-screw group showing the highest load to failure. The stiffness of the 7-screw group was superior compared with the 6-screw, 9-screw, and 4-screw groups. The maximum displacement before failure showed a significant difference between the comparative groups with the 4-screw group having the lowest value. The 7-screw group had the least structural failure rate (33.3%). Conclusion: At least 7 screws would be optimal for proximal fragment fixation of proximal humerus fractures with medial comminution to minimize secondary varus collapse or fixation failure. Level of Evidence: Basic science study.

scholarly journals Fixation of proximal humerus fracture in adult by locking plate: Clinical study

2020 ◽  
Vol 6 (5) ◽  
pp. 325-332
Author(s):  
Dr. Vivek Amritbhai Patel ◽  
◽  
Dr. Vishal A. Pushkarna ◽  
Dr. Dhruvin J. Patel ◽  
◽  
...  
Keyword(s):  
Functional Outcome ◽  
Proximal Humerus Fracture ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Humeral Fracture ◽  
Humerus Fracture ◽  
Functional Evaluation ◽  
Locking Plates ◽  
Radiological Union

p>Aim: The present study aimed to examine the functional outcome of the locking plate in theproximal humerus fracture treatment. Material and Methods: The study consists of 20 patientsdiagnosed with NEER’s 2 – part, 3- part, and 4 – part proximal humerus fracture. All the includedpatients were treated with internal locking plates. Based on the functional evaluation by Constant-Murley shoulder score and the assessment of radiological union foundation. Results: Excellentresults were obtained in 45% of the patients, a good result was seen in 25%, 20% of the patientshad fair results and the poor result was seen in 10% of the patients. The mean Constant-Murleyshoulder score that was obtained in the present study was 75.04. Conclusion: It’s concluded thatthere is a satisfactory functional outcome with the fixation of the proximal humerus fracture withlocking plates. While using the plate fixation for fracture the plate position is of the utmostimportance. Due to angular stability, the locking plates are the advantageous implants in case ofproximal humeral fracture.

scholarly journals Functional outcome of displaced proximal humerus fractures managed by proximal humerus interlocking system plate

2017 ◽  
Vol 3 (3) ◽  
pp. 583
Author(s):  
C. D. Deepak ◽  
Mahesh D. V. ◽  
Abdul Ravoof ◽  
Manash Jyoti Baruah
Keyword(s):  
Functional Outcome ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Road Traffic ◽  
Osteoporotic Fractures ◽  
Humerus Fracture ◽  
Distal Radial Fractures ◽  
Patients Âgés ◽  
Philos Plate ◽  
The Right

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Fractures of the proximal humerus are the second most common upper extremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The study was conducted in patients treated for displaced proximal humerus fracture at Adichunchanagiri Institute Of Medical Sciences, BG Nagar from the month of June 2014 to August 2016. Twenty proximal humerus fracture patients were taken into the study; all were fixed with PHILOS plate. Patients’ age ranged from 18 to 75 years with a mean of 42.9</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The sample consisted of twenty patients of proximal humeral fractures. 08 were males and 12 females. The patients’ ages ranged from 18-75 years with a mean age of 42.9 years. The causes of fractures were road traffic accident in 13 patients, fall in 06 patients and electric shock in 1 patient. 11 fractures involved the right side and 09 involved the left. Patients were followed up from 03 weeks to 06 months. Functional outcome was rated as per Constant-Murley Shoulder Score, we got excellent results in 04 cases, satisfactory in 10, unsatisfactory in 05 xi and failure in 01 patient. Mean Constant-Murley score of this study at the end of the final follow-up period was 81.6. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The PHILOS plate is a good implant to use for fractures of the proximal humerus. However, proper placement of the plate and fixation are required to produce satisfactory results. We recommend use of this implant in Neer 2-part, 3-part, 4-part fractures with or without dislocation and osteoporotic fractures.</span></p>

scholarly journals Functional outcome of proximal humerus fracture using PHILOS plating

2020 ◽  
Vol 6 (4) ◽  
pp. 367-371
Author(s):  
Dr. S Saran Prasath ◽  
Dr. R Neelakrishnan ◽  
Dr. V Bharathiselvan ◽  
Dr. PS Balamurgavel ◽  
Dr. K Parasuraman ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture

scholarly journals Short and medium term functional outcome of hemi-replacement in complex proximal humerus fracture

2020 ◽  
Vol 6 (4) ◽  
pp. 810
Author(s):  
Niranjan Tadvi
Keyword(s):  
Functional Outcome ◽  
Traffic Accidents ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Road Traffic ◽  
Total Shoulder Arthroplasty ◽  
The Elderly ◽  
Humerus Fracture ◽  
Complication Rates ◽  
Constant Murley Score

<p class="abstract"><strong>Background:</strong> Complex proximal humerus fractures are common injuries are common just because of high incidence of road traffic accidents and old age population. The aim of this study was to evaluate the functional outcome in hemi-replacement in complex 3and 4 part of proximal humerus fracture.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the Department of Orthopaedics, Sir. T. Hospital, Bhavnagar from August 2010 to April 2014. Out of 30 patients 27 turned up for follow up 3 was lost. Functional and clinical assessments using the age and gender specific Constant-Murley score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Excellent to good outcome as per Constant-Murley score was seen in 16 patients, moderate outcome in 8 patients and poor outcome in 3 patients.</p><p class="abstract"><strong>Conclusions:</strong> To spare proximal humerus in younger patients there should be do osteosynthesis procedure with every effort. In the elderly, especially with more complex four-part fractures and fracture dislocations, hemiarthroplasty and reverse total shoulder arthroplasty are specified to decrease complication rates and improve functional outcomes.</p>

scholarly journals Functional outcome following surgical management of proximal humerus fracture in elderly

2017 ◽  
Vol 3 (4f) ◽  
pp. 386-389
Author(s):  
Dr. Vanka Ashok Kumar ◽  
Dr. Raghuveer Adiga ◽  
Dr. Abhishek S Bhasme ◽  
Dr. Ram Prasad Rai ◽  
Dr. Terence D souza
Keyword(s):  
Functional Outcome ◽  
Surgical Management ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture
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