Journal of Research in Applied and Basic Medical Sciences (Apr 2023)
A study to evaluate functional outcome of various treatment modalities (surgical) of proximal humerus fracture
Abstract
Background & Aims: Proximal humerus fractures comprise almost 5.7% of all fractures and represent the most common humerus fractures (80%). In addition, proximal humeral fractures (PHFs) are the third most common fracture in geriatric patients, typically associated with systemic osteoporosis. Their incidence is expected to triple over the coming three decades. This study aims to evaluate the functional outcome of various treatment modalities (Surgical) for Proximal humerus fracture treatment modalities (Surgical) of Proximal humerus Fracture. Materials & Methods: This study is a prospective and analytical one. The patients admitted to the orthopaedics ward with fractures of the proximal humerus in the adult age group (above 18) were screened and recruited based on the fulfilment of inclusion and exclusion criteria. Fifty patients were taken in which plain radiographs of the shoulder (trauma series, i.e. AP, lateral and axillary view), CT scan if needed, and routine pre-anaesthetic investigations were assessed. For statistical analysis, data were entered into a Microsoft excel spreadsheet and then analyzed by SPSS (version 27.0; SPSS Inc., Chicago, IL, USA) and GraphPad Prism version 5. Two-sample t-tests for a difference in mean involved independent samples or unpaired samples. Results: In our study, 18(36.0%) patients were treated with closed reduction + percutaneous pinning, 9 (18.0%) patients were treated with hemiarthroplasty, and 23(46.0%) patients were treated with open reduction and internal fixation with PHILOS plate. In our study, 13 (26%) patients had four-part fractures, out of which 5(10.0%) patients had four-part fractures with head split, 23(46.0%) patients had three-part fractures, and 14(28.0%) patients had two-part fractures. In our study, 10(20.0%) patients had Abduction Score 4 (61-90), 22(44.0%) patients had Abduction Score 6 (91-120) and 18(36.0%) patients had Abduction Score 8 (121-150). Conclusion: Good surgical skills and experience of the surgeon in the selection are necessary to achieve the correct and best outcome irrespective of the surgical modality chosen. Proper patient selection and thorough knowledge of anatomy and biomechanical principles are the prerequisites for successful surgery and good functional outcome.
