Analysis of surgical management of proximal humeral fractures

Abstract

Aim: To assess the outcome of fractures of proximal humerus managed surgically. Materials and Methods: This prospective clinical study is an analysis of 22 cases of surgically managed proximal humeral fractures, undertaken at the Department of Orthopaedics & Traumatology, Govt. General Hospital, Chennai. Standard anteroposterior radiographs of the affected shoulder were taken in all patients and most of them were further evaluated with Neer’s three view trauma series. CT scan was done in patients with complex fracture dislocations, to delineate the fracture pattern and the direction of dislocation. The indications for surgery were displacement more than 1cm and angulation > 450. Patients not satisfying these criteria were treated conservatively and not included in this study. All the patients were operated by the standard anterior deltopectoral approach. All the patients were followed up monthly for the first 3 months and later every 3 months. During follow-up patients were clinically evaluated for pain, function and rotation. Radiological evidence of fracture union was observed by serial x-rays. Result: Majority of the injured patients were males (72%). Mean age of the study population was 36.75 years. RTA was the most common mode of injury (36.3%). There were no bilateral fractures; all were right handed persons and the dominant arm was involved in 16 (72.7%) patients. Early complications were encountered in 6 (25%) patients and late complications were encountered in 8 (30%) patients Conclusion: This study concluded that functional outcome of two part fractures is better than three part and four part fractures and the results are better with fractures than with fracture dislocations.