Evaluation of Functional Outcome of Management of Proximal Humerus Fractures by Different Treatment ModalitiesCorrespondence Address :
Sudhir Shyam Kushwaha,
Flat No. 502, I-Block, Rapti Apartment, Gomti Nagar Extension, Lucknow, Uttar Pradesh, India.
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 we can conclude that locking plates are an excellent modality of treatment of proximal humerus fractures with excellent union rate and early mobilisation.
Constant scoring system, Joshi external stabilisation system, K-wire, Locking compression plate, Swanson shoulder score
Date of Submission: Feb 28, 2017
Date of Peer Review: Mar 22, 2017
Date of Acceptance: Jun 02, 2020
Date of Publishing: Jul 01, 2020
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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