E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


Study of operative management for complex fracture of upper end of Humerus

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah.

Abstract
Background: Proximal humerus fractures are very common fractures occurring in the skeleton. They account for approximately 4 – 5% of the fracture attendance at the hospital. It is the most common fracture of shoulder girdle. It is the 3rd most common fracture in elderly. Till date various methods are used including percutaneous and open reduction & fixation according to fracture type.

Aims & Objective: To study the occurrence, mechanism of injury and displacement of various types of fractures and different modalities of the fixations in proximal humerus fractures. Come to conclusion about preferred modality of treatment of proximal humerus fractures according to the pattern of fracture.

Material and Methods: In present study 44 patients of complex fracture of proximal humerus treated with either open reduction internal fixation or percutaneous fixation from 2009 to 2012. Follow up assessment was done by Constant score.

Results: Radiological union occur at about 8 to 12 weeks. Closed reduction and percutaneous k wire or cancellous screws fixation showed excellent results in majority cases of 3 -part fracture. All 4 part fractures are treated with ORIF. Open reduction and internal fixation with locking compression plates showed good results among all implants used.

Conclusion: 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, should be applied. Majority of poor results are due to poor surgical techniques and lack early physiotherapy.

Key words: Complex Proximal Humerus Fracture; Locking Plate; Percutaneous Fixation; Hemiarthroplasty; Deltopectoral Approach


 
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REFERENCES
1. Bucholz RW, Heckman JD, Court-Brown C. Rockwood and Green's fractures in adults. 6th edi. Philadelphia, PA: Lippencott, Williams & Wilkens. 2008. p. 1162-80.
2. Trumble TE, Budoff JE, Cornwall R. Core Knowledge in Orthopedics: Hand, Elbow and Shoulder. Philadelphia: Mosby Elsevier science. 2005.
3. Rockwood CA Jr, Matsen FA III, Wirth MA, Loppitt SB. The Shoulder. 4th edi. Philadelphia, USA: Saunders Elsevier. 2008.
4. Brooks CH, Revell WJ, Heatley FW. Vascularity of the humeral head after proximal humeral fractures: an anatomical cadaver study. J Bone Joint Surg Br. 1993;75(1):132-6.
5. Keener JD, Parson BO, Flatow EL, Rogers K, Williams GR, Galatz LM. Outcomes after perculaneous reduction and fixation of proximal humerus fractures. J Bone Joint Surg. 2007;16(3):330-8.
6. Robinson CM, Page RS. Severely impacted Valgus proximal humerus fractures. J Bone Joint Surg Am. 2004;86(2):143-55.
7. Mighell MA, Kolm GP, Collinge CA, Frankle MA. Outcomes of hemiarthroplasty for fracture of proximal humerus. J Shoulder Elbow Surg. 2003;12(6):569-77. [DOI via Crossref]   
8. Neer CS II. Shoulder reconstruction. Philadelphia: WB Saunders; 1990.
9. Sudkamp NP, Audige L, Lambert S, Hertel R, Konrad G. Path analysis of factors for functional outcome at one year in 463 proximal humerus fractures. J Shoulder Elbow Surg. 2011; 20(8):1207-16. [DOI via Crossref]   
10. Meyer DC, Fucentese SF, Koller B, Gerber C. Association of osteopenia of the humeral head with full-thickness rotator cuff tears. J Shoulder Elbow Surg. 2011;13(3):333-7. [DOI via Crossref]   
11. Gruson KI, Ruchelsman DE, Tejwani NC. Isolated tuberosity fractures of proximal humerus: current concepts. Injury 2008;39(3):284-98. [DOI via Crossref]   
12. Konrad G, Bayer J, Hepp P, Voigt C, Oestern H, Kההb M, et al. Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. Surgical technique. J Bone Joint Surg Am. 2010;92(Supp 1):85-95. [DOI via Crossref]   
13. Levine W, Murra G, Bigliani L. Fracture of shoulder girdle. New York NY: Marcel Dekker. 2003.
14. Naranja RJ Jr, Iannotti JP. Displaced three- and four part proximal humerus fractures: Evaluation and management. J Am Acad Orthop Surg. 2000;8:373- 82.
15. Canale ST, Beaty JH. Cambell Operative Orthopedics. 9th edi. St. Louis: CV Mosby. 2009. p. 3376-88.
16. Bigliani LU, Flatow EL, Pollock RG. Fractures of proximal humerus. In: Rockwood CA, Matsen FA (Eds). The shoulder. 2nd edi. Philadelphia, PA: Saunders 1998. p. 337-89.
17. Fabre T, Piton C, Leclouerec G, Gervais-Delion F, Durandeau A. Entrapment of the suprascapular nerve. J Bone Joint Surg Br. 1999;81(3):414-9. [DOI via Crossref]   
18. El-Sayed MM, Seleem OA. Hind-foot correction and stabilization by pins in plaster after surgical release of talipes equino varus feet in older children. J Orthop Surg Res. 2010;5:42. [DOI via Crossref]   

How to Cite this Article
Pubmed Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah. Study of operative management for complex fracture of upper end of Humerus. Int J Med Sci Public Health. 2013; 2(4): 940-945. doi:10.5455/ijmsph.2013.150720131


Web Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah. Study of operative management for complex fracture of upper end of Humerus. https://www.ijmsph.com/?mno=40672 [Access: April 05, 2022]. doi:10.5455/ijmsph.2013.150720131


AMA (American Medical Association) Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah. Study of operative management for complex fracture of upper end of Humerus. Int J Med Sci Public Health. 2013; 2(4): 940-945. doi:10.5455/ijmsph.2013.150720131



Vancouver/ICMJE Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah. Study of operative management for complex fracture of upper end of Humerus. Int J Med Sci Public Health. (2013), [cited April 05, 2022]; 2(4): 940-945. doi:10.5455/ijmsph.2013.150720131



Harvard Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah (2013) Study of operative management for complex fracture of upper end of Humerus. Int J Med Sci Public Health, 2 (4), 940-945. doi:10.5455/ijmsph.2013.150720131



Turabian Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah. 2013. Study of operative management for complex fracture of upper end of Humerus. International Journal of Medical Science and Public Health, 2 (4), 940-945. doi:10.5455/ijmsph.2013.150720131



Chicago Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah. "Study of operative management for complex fracture of upper end of Humerus." International Journal of Medical Science and Public Health 2 (2013), 940-945. doi:10.5455/ijmsph.2013.150720131



MLA (The Modern Language Association) Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah. "Study of operative management for complex fracture of upper end of Humerus." International Journal of Medical Science and Public Health 2.4 (2013), 940-945. Print. doi:10.5455/ijmsph.2013.150720131



APA (American Psychological Association) Style

Archit Shashankkumar Gandhi, Parimal Jayantilal Patel, Bhavik Y Dalal, Rohit B Shah (2013) Study of operative management for complex fracture of upper end of Humerus. International Journal of Medical Science and Public Health, 2 (4), 940-945. doi:10.5455/ijmsph.2013.150720131





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