Functional outcome following surgical management of proximal humerus fracture in elderly

Author(s): Dr. Vanka Ashok Kumar, Dr. Raghuveer Adiga, Dr. Abhishek S Bhasme, Dr. Ram Prasad Rai and Dr. Terence D souza

Abstract: Proximal humerus fracture accounts to about 4-5% of all the fractures and is the third most common fracture in the elderly population. Though several modalities of treatment exist there are no clear guidelines or consensus to the optimal method of treatment of these fractures especially in the elderly population. This study was based in a tertiary hospital with the objectives to assess the functional outcome of surgical treatment of proximal humerus fractures in the elderly population. Patients with proximal humerus fracture aged above 51 years and fulfilling the inclusion criteria were included in the study. The fractures were classified using Neer’s classification of proximal humerus fracture. Patients were treated surgically by [ORIF] and post-operatively limb is immobilized in arm pouch; mobilization was started at the second week as per patient’s tolerance. Patients were then followed up at 3 months, 6months and 12 months.They were assessed for functional outcome using Constant scoring system [Pain, activities of daily living and range of motion]. A total of 37 patients were included in the study. The mean age of the patients was 65.2 years. The study included 18 2-part fracture, 11 3-part fractures and 8 4-part fracture. The mean Constant score at 12-month follow-up in 2-part fracture was 66.2, in 3-part fracture was 59 and in 4-part fracture was 51.4. The overall mean Constant score was 60.2. In conclusion we areof opinion that treatment of proximal humerus fractures in the elderly population is a challenge and one should not deny them a good functional outcome. Patients with 2-part fracture fared better and has a satisfactorily good functional outcome. Whereas in 3-part and 4-part fractures the outcomes do not vary significantly and patients with 4-part fracture had higher incidence of surgery related complication.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4f.51