A prospective study of functional outcome in displaced fractures of the proximal humerus managed surgically

Abstract

Background: The aim of the study is to evaluate the functional outcome of displaced fractures of the proximal humerus managed surgically.Methods: A prospective analysis of the functional outcome of 20 cases under surgically managed displaced proximal humeral fractures were undertaken in our hospital. The indications of the surgery were displacement to more than 1 cm and angulation of more than 45°. The patients were operated by the standard anterior deltopectoral approach, deltoid splitting or percutaneous procedure depending upon the type of fracture and bone quality. Results: The mean age of the patients was 44 years. The mode of injury was fall at ground level in 10(50%) patients, road traffic accident in 6(30%) patients, fall from height in 3(15%) patients, fall due to epilepsy in 1(5%) patients. Based on Neer’s sytem 10 patients (50%) had two part fractures, 5(25%) patients had 3 part fractures and 5(25%) had four part fractures. Greater Tuberosity fractures were the predominant type in 2 part fracture. Patients underwent the surgery on an average of 7.95 days after injury. The mean follow-up period in this study was 12.2 months. Conclusion: Displaced proximal humeral fractures when treated surgically produce less pain, less stiffness and greater range of motion. Earlier the surgery better are the results. Results are better with fractures than with fracture dislocations. Results are best when operative method results in stable fixation that allows early passive mobilization. Functional outcome of 2 part fractures is better than 3 part and 4 part fractures.