Evaluation of the Outcome of Proximal Humerus Fracture Managed By Internal Locking Plate- A Prospective Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 5
Abstract
Background And Objective: Proximal humerus fractures accounts for about 4 to 5% of all fractures. They are the third most common fractures in elderly population after hip and distal radius fractures. Regarding treatment of proximal humerus fractures, controversies still exists whether to do conservative or operative management. Various operative procedures are carried out, recent trend in internal fixation has moved on to locking plates which gives angular stability. The present study is undertaken to evaluate the functional outcome and complications of proximal humerus fractures treated by PHILOS locking plate. Methods: Prospective study involving Adults(18-60years) with proximal humerus fractures admitted to Jubilee Mission Medical College And Research Institute in the period from January 2015 to December 2015. In this study 30 cases of fractures of proximal humerus were treated by open reduction and internal fixation with PHILOS locking plate and followed up for six months. Patients were followed up in outpatient department at first, second, third and sixth months Serial radiographs were taken for assessing complications and the functional outcomes were assessed using Constant and Murley score. Results And Discussion: In our series, male female incidence were equal with majority of patients sustaining fracture following road traffic accident. Average age of patients were 43±11.65 and most common fracture pattern observed in these patients were 3 part fracture (33.3%). 66% of the fractures united within three months and 94% of the fracture united within six months. Average constant score of 65.13 was achieved. Overall complication rates were 20% with one case of osteonecrosis of humeral head. 10% of the patient needed a second unplanned surgery. Fracture pattern and complications had significant impact on the functional outcome of the patient. Conclusion: Internal fixation with PHILOS plate is reliable operative option for displaced proximal humerus fracture which provides angular stable fixation, especially in a osteoporotic bone. High rate of complications depends both on implant design and operative technique. Therefore, attention on technical aspects of applying them would help optimization of the results.
Authors and Affiliations
Dr. T M Jose, Dr. Ajith Vincent, Dr Anil George Paul
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