The proximal humerus fracture is of great importance when it affects the young and middle age groups of the population as it leads to temporary disability and loss of working hours. Restoration of the function of the limb becomes the primary goal of its treatment. Principle of fixation is reconstruction of the articular surface, including the restoration of the anatomy, stable fixation, with minimal injury to the soft tissues preserving the vascular supply. The present study was conducted to analyze the occurrence, mechanism of injury and displacement of various types of proximal humerus fractures and further evaluate the functional outcome of different modalities of its management.
Methods: The following study was conducted at C U Shah Medical College and Hospital, Surendranagar, Gujarat during the period of June 2012 to June 2014. Total 50 patients, 22 males and 28 females with proximal humerus fractures treated with different modalities were selected for the study and assessed by Constant and Murley scoring system with at least 1 year follow up. Results: The average age of patients was 55.6 years out of which 56% were female. Domestic fall was the most common mode of injury (64% patients). Two part surgical neck fractures (Neer’s) accounted maximum number of the patients (34%). All One parts and most of the two part fractures treated conservatively. Most of the three part fracture treated with Open reduction and proximal humerus anatomical locking plates. Most common complication was malunion whereas one patient had implant loosening as complication. The average constant score at final follow up for all conservatively treated patients was 75.69, for patients treated by close reduction and percutaneous K wire fixation was 82.79 and for patients treated by open reduction and internal fixation with anatomical locking plate was 73.6.
Conclusion: Early Open Reduction and Internal fixation prevents complications like shoulder stiffness, malunion, and late osteoarthritis. Open reduction and rigid internal fixation with proximal humerus plates becomes the choice of treatment for young adults with displaced fractures, whereas fractures in old aged patients with osteoporosis gave good outcome with conservative modality of management. There is also a direct relationship between displaced proximal humerus fractures, fracture severity and eventual results.