Surgical management of proximal humerus fractures – Assessment of results

Introduction: Proximal humeral fracture whether caused by trauma or related to osteoporosis, requires carefully planned individual treatment. The choice of technique and devices depends on quality of bone, soft tissue, age and reliability of patients. However the goal of proximal humerus fracture fixation should be stable reduction, allowing early motion of fracture. Objectives: To analyze fractures of the proximal humerus that were treated either with the proximal humerus internal locking system (PHILOS) locking plate or percutaneous K wire and document their clinical and functional outcome. Materials and Method: The study includes patients with proximal humerus fractures who underwent Open reduction and internal fixation with PHILOS locking plate or Percutaneous K-wire fixation. Functional outcome was evaluated by Constant-Murley score. Patients were followed up at 6 weekly interval until fracture union and at once at 1 yr after the surgery 30 cases were studied, cases were selected randomly for both PHILOS and percutaneous k wire fixation, each 15 cases. Results: 33.34% patients treated with open reduction and internal fixation with PHILOS plating had good to excellent results, 46.6% of patients had fair results and the remaining 20% had poor results. 40% of patients treated with closed reduction and K wire fixation had good to excellent results, 40% of patients had fair results and remaining 20% had poor results. Conclusion: The results of surgical treatment of proximal humerus fractures in both the groups (percutaneous pinning and PHILOS plating) are satisfactory with good functional outcome.