COMPARATIVE EVALUATION OF FUNCTIONAL OUTCOME OF OPEN REDUCTION AND INTERNAL FIXATION WITH PHILOS AND CLOSED REDUCTION AND PERCUTANEOUS FIXATION WITH K-WIRES IN PROXIMAL HUMERAL FRACTURES

2021 ◽  
pp. 44-47
Author(s):  
Atul K. Dwivedi ◽  
Lakhan Singh Maravi ◽  
H. S. Varma ◽  
Ashish Sirsikar
Keyword(s):  
Functional Outcome ◽  
Closed Reduction ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Percutaneous Fixation ◽  
Group A ◽  
Humerus Fractures ◽  
K Wires ◽  
Group B ◽  
A Prospective Study

Background: Fracture of the proximal humerus represents the second most common (29.1%) fracture type in the upper extremity after Colle's fracture (37.2%) of the wrist. Signicant controversy continues regarding the best modality for treating displaced proximal humerus fractures. The objective of our study is to comparatively evaluate the functional outcome of ORIF with Proximal Humerus Internal Locking System (PHILOS) and Close Reduction and Percutaneous Fixation with K-wires in proximal humerus fractures. Method: A prospective study was conducted after getting ethical approval at N.S.C.B. Medical College & Hospital, Jabalpur, (M.P.) upon 50 cases admitted with proximal humerus fractures as per inclusion criteria. 25 cases were treated with PHILOS plate in group A and 25 patients were treated with Closed Reduction and Percutaneous Fixation with K-wires in group B. Post op follow up was done at 6 weeks and 12 weeks and functional outcome evaluated by Neer's scoring criteria. Results: Out of 50 cases, excellent scores was obtained in 22 (88%) cases treated with PHILOS in group A, and 18 (72%) cases treated with k-wire xation in group B, satisfactory score was obtained in 3 (12%) in Group A and 6 (24%) in Group B. Conclusion: We obtained excellent results in both groups with each procedure having its own advantage and disadvantages. We found that PHILOS provides secure xation with better functional outcome in terms of range of motion. Fixation with Percutaneous K-wires is also efcient treatment option with intraoperative advantage in terms of invasiveness, blood loss and time taken for surgery with least tissue dissection than PHILOS plating

scholarly journals Evaluation of Functional Outcome of Management of Proximal Humerus Fractures by Different Treatment Modalities

2020 ◽  
Author(s):  
Sudhir Shyam Kushwaha ◽  
Ambrish Thakur ◽  
Yasir Ali Khan ◽  
Amit Verma ◽  
Farid Mohammed ◽  
...  
Keyword(s):  
Locking Plate ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Early Mobilisation ◽  
Group A ◽  
Humerus Fractures ◽  
Group B ◽  
Group D ◽  
Shoulder Score

Introduction: Proximal humerus fractures account for 4-5% of all fractures and could be managed both conservatively and surgically. As much as 85% minimally or non-displaced fractures can be managed conservatively. In spite of early union and exercise programme by conservative treatment, the problem of shoulder stiffness is common. To overcome stiffness, early mobilisation is mandatory which is not possible in conservative treatment before three weeks. Therefore, surgical intervention is needed for early mobilisation and early return of function. Aim: To compare the functional outcome between the four common methods of managing proximal humerus fractures namely locking plate, Joshi External Stabilisation System (JESS), percutaneous K-wire fixation and conservative method. Materials and Methods: Patients with proximal humerus fracture above 18 years of age between August 2011 to August 2013 were included in the study. The study population was divided into four groups viz., Group A, B, C, D depending on the mode of treatment by locking plate, external fixator, K-wire fixation and conservative method of treatment, respectively. The patients were followed-up at 3 weeks, 6 weeks, 12 weeks, 18 weeks and thereafter every 6 weeks’ interval till 9 months. After union, cases were evaluated radiologically and clinically for functional results by using the Swanson Shoulder Score and Constant Scoring System (Modified). Results: At the end of the study there were 17 patients in the Group ‘A’, 7 patients in the Group ‘B’, 7 patients in the Group ‘C’ and 11 patients in Group ‘D’. At 9 months of follow-up according to modified constant shoulder score the percentage of excellent score in group A was maximum. Group B and Group D had maximum number of good scores. The mean constant shoulder score increased in all groups at 9 months of follow-up as compared to 3 months of follow-up except in group D. Similarly, according to Swanson’s shoulder score, group A had the maximum number of excellent scores. Conclusion: From the above study it can be concluded locking plates are an excellent modality of treatment of proximal humerus fractures with excellent union rate and early mobilisation.

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