Minimally invasive treatment of proximal humerus fractures with locking compression plate improves shoulder function in older patients: study protocol for a prospective randomized controlled trial

2016 ◽  
Vol 1 (2) ◽  
pp. 0 ◽  
Author(s):  
Tao Wu ◽  
Guo-qiu Zhang
Keyword(s):  
Older Patients ◽  
Proximal Humerus ◽  
Controlled Trial ◽  
Shoulder Function ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Invasive Treatment ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Humerus Fractures

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

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.

scholarly journals Surgical management of proximal humerus fracture treated with locking compression plate

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p><strong>Conclusions:</strong> 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.</p>

scholarly journals Proximal Humerus Fractures: Evaluation and Management in the Elderly Patient

2018 ◽  
Vol 9 ◽  
pp. 215145851775051 ◽  
Author(s):  
Adam Schumaier ◽  
Brian Grawe
Keyword(s):  
Risk Factors ◽  
Proximal Humerus ◽  
The Elderly ◽  
Controlled Trials ◽  
Proximal Humerus Fractures ◽  
Locking Plates ◽  
Intramedullary Nails ◽  
Surgical Risk ◽  
Randomized Controlled ◽  
Humerus Fractures

Introduction: Proximal humerus fractures are common in the elderly. The evaluation and management of these injuries is often controversial. The purpose of this study is to review recent evidence and provide updated recommendations for treating proximal humerus fractures in the elderly. Methods: A literature review of peer-reviewed publications related to the evaluation and management of proximal humerus fractures in the elderly was performed. There was a focus on randomized controlled trials and systematic reviews published within the last 5 years. Results: The incidence of proximal humerus fractures is increasing. It is a common osteoporotic fracture. Bone density is a predictor of reduction quality and can be readily assessed with anteroposterior views of the shoulder. Social independence is a predictor of outcome, whereas age is not. Many fractures are minimally displaced and respond acceptably to nonoperative management. Displaced and severe fractures are most frequently treated operatively with intramedullary nails, locking plates, percutaneous techniques, or arthroplasty. Discussion: Evidence from randomized controlled trials and systematic reviews is insufficient to recommend a treatment; however, most techniques have acceptable or good outcomes. Evaluation should include an assessment of the patient’s bone quality, social independence, and surgical risk factors. With internal fixation, special attention should be paid to medial comminution, varus angulation, and restoration of the calcar. With arthroplasty, attention should be paid to anatomic restoration of the tuberosities and proper placement of the prosthesis. Conclusion: A majority of minimally displaced fractures can be treated conservatively with early physical therapy. Treatment for displaced fractures should consider the patient’s level of independence, bone quality, and surgical risk factors. Fixation with percutaneous techniques, intramedullary nails, locking plates, and arthroplasty are all acceptable treatment options. There is no clear evidence-based treatment of choice, and the surgeon should consider their comfort level with various procedures during the decision-making process.

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