A Prospective Study on Clinical Outcome following Surgically Managed Displaced Proximal Humerus Fractures using Proximal Humerus Internal Locking System

Proximal humerus fractures encompass a broad spectrum of injuries. They are often the result of a fall in an osteoporotic patient, but also occur in high-energy trauma. These account for 4 -5 % of all fractures and incidence increase rapidly with age. Functional results associated with non-operative treatment of displaced fracture of proximal humerus are poor. Over the last decades, several techniques have been applied for treatment of proximal humerus fractures. Widely accepted is the initiation of a conservative treatment regimen for undisplaced fractures, however, the ideal treatment of displaced fractures, especially 3 and 4 part fractures is still the center of scientific debate. In our hospital 30 patients with 30 proximal humerus fractures were treated with locking compression plate from January 2014 to January 2016. Among these, 16 were males and 14 were females. Youngest patient was 24 years and oldest was 65 years. Fractures were classified according to Neers classification& type 2, 3,& 4 were included in the study. Post operatively rehabilitation started depending upon stability of fixation and tolerability of patient. According to Neers scoring system approximately 60 % of patients had satisfactory to excellent results, 30 % had fair results and 10 % had unsatisfactory to poor results. Materials& Methods Design A prospective study. Duration January 2014 - January 2016. Sample 30 patients with displaced proximalhumerus fractures were treated surgically by PHILOS. Inclusion criteria Age Patients with skeletal maturity and Displaced proximal humerus fractures (Neers type2, 3, 4). Exclusion criteria Neers type 1 undisplaced fracture and Fractures associated with scapular neck fractures and clavicular fracture. They were followed up for a minimum period of 1 year by the senior author and evaluated for clinical outcome using X-RAYS, subjective evaluation, range of movements, complication according to Neers scoring system. Results Out of 30 cases 27 cases had excellent results without complications.1 patient had partial necrosis of head with minimal functional limitation.1patient had implant back out but the patient is protected till the fracture united.1 patient had collapse at fracture site with secondary penetration of screw into the joint. Conclusion In our study of 30cases of displaced proximal humerus fractures, were effectively treated surgically with PHILOS gave good to excellent results& to be considered a good surgical modality for displaced proximal humerus management fracture management.