Evaluation of Functional Outcome of Management of Proximal Humerus Fractures by Different Treatment Modalities
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 pro...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2020-07-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/13830/27961_CE[Ra1]_F(KM)_PF1(Kri_SL)_PN(SL).pdf |
| Summary: | 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 it can be concluded locking
plates are an excellent modality of treatment of proximal humerus
fractures with excellent union rate and early mobilisation. |
|---|---|
| ISSN: | 2249-782X 0973-709X |