European Journal of Molecular & Clinical Medicine

Objective: To evaluate the clinical and functional outcome of proximal humerus fractures in adults treated with locking compression plate.
Methods: Range of motion, time to radiological sign of union, and validated outcome measures-i.e., Oxford, UCLA and NEER’S score-were assessed in a prospective study of fifty patients (thirty-eight men and twelve women with a mean age of 42.44 years) of proximal humerus fractures treated with open reduction internal fixation with locking compression plate. The duration of follow-up was 6 months and standardized radiographs of the shoulder were evaluated.
Results: All fractures went for union clinically and radio-logically. The average time for union was 12.76 weeks (average 10.58 weeks for two-part fractures, 12.78 weeks and in three-part fractures and 14.28 weeks in four-part fractures). The average NEER’s score out of 100 was 81.1 (minimum score 48, maximum score 95) with excellent results (score 90-100) in 5 patients (10%), 30 patients (60%) showing satisfactory results (score 80-89), 12 patients (24%) with unsatisfactory results (score 70-79) and 3 patients (6%) had a poor result (score <70). As per the UCLA Score out of 35, the average score was 27.48 (minimum score 15 and maximum of 34) showing good/excellent results (score >27) in 31 patients (62%) and fair/poor results (score <27) in 19 patients (38%). Post-operative shoulder arthritis was assessed by using Oxford score. The average score out of 48 was 40.02 (minimum score18, maximum score 47) showing satisfactory joint function and no signs of arthritis (score 40-48) in 36 patients (72%), mild to moderate shoulder arthritis (score 30-39) 10 patients (20%), moderate to severe arthritis (score 20-29) in 2 patients (4%) and severe arthritis (score 0-19) in 2 patients (4%). The complications observed were, shoulder stiffness in 5 patients (10%), radiological features of avascular necrosis of head of humerus in 3 patients (6%), plate impingement in 1 patient (2%) and infection in 1 patient (2%) which resolved uneventfully with help of antibiotics. No patient suffered non-union or varus malunion.
Conclusion: Observations of fifty cases of proximal humerus fractures treated with locking compression plate shows the advantages of stable internal fixation, early mobilization, and functional restoration, combined with unlikely secondary loss of reduction. Accurate

Background: Proximal humerus fractures are common and debilitating injuries and the incidence of them are increasing especially in the elderly. Treatment of unstable, displaced, and comminuted proximal humerus fractures remain challenging. Significant controversy continues regarding the best methods of treating displaced proximal humerus fractures. The treatment goal is to achieve a painless shoulder with a fully functional outcome. Regarding the treatment of proximal humerus fractures, controversies still exist about whether to do conservative or operative management. Various operative procedures are carried out like percutaneous pinning, tension band wiring, platting, and rush nailing. A recent method of internal fixation is with locking plates. PHILOS plates provide rigid fixation and more angular stability compared to other methods of operative treatment of proximal humerus fractures and help in early mobilization and physiotherapy which leads to achieving a painless shoulder with a good functional outcome.
Materials and Methods: Patients with fractures of the proximal humerus admitted to our centre between August 2020 to July 2021 will be taken up for study after obtaining consent. Clinical evaluation was done by the Constant Murley score. Fractures are classified using Neer s classification. A minimum of 24 cases are studied.
Results: In conclusion locking Compression plate is an advantageous implant in proximal humeral fractures due to angular stability, particularly in comminuted fractures and in Osteoporotic bones in elderly patients, thus allowing early mobilization.

Introduction: Proximal humerus fractures are one of the commonest fractures occurring in the skeleton representing approximately 4% of all fractures and 26% of humerus fractures. Fractures that occur in the elderly usually result from a trivial fall on an outstretched hand or the side of the shoulder. Younger patients with these injuries are more likely due to high energy trauma following road traffic accidents and present with significant associated injuries. Aim: To evaluate the outcome of open reduction and internal fixation using locking compression plate for proximal humeral fractures.

An elderly male presenting to theOrthopaedics OPD with complaints of pain and swelling over left shoulder for 2 days with a history of trauma. Radiological investigations were done and suggestive of Left proximal humerus fracture with multiple displaced fragments with Acromioclavicular joint arthropathy¹. After extensive planning, he was operated on with left hemiarthroplasty. Post-op regular follow up undertaken and post-op rehabilitation under expert guidance

Introduction: Proximal humerus fractures account for 4-5% of all fractures, it is the second most common fracture of the upper extremity, these fractures have a bimodal age distribution. Women are affected more than men. About 80% of these fractures are un-displaced according to NEER’s criteria and, only 20% are displaced and require operative interference. However various methods of internal fixation have been proposed, for full functional recovery anatomical reduction, stable fixation, early mobilisation are required. The blood supply of the head of the humerus is at risk, however not only from the injury also from the dissection of soft tissues at ORIF. The incidence of mal-union, non-union and avascular necrosis (AVN) after percutaneous pinning is less and limited exposure and minimal dissection of the soft tissues at the fracture site is recommended. Our aim was to evaluate the functional outcomes of proximal humerus fractures treated with multiple percutaneous k wires.
Methods: This is a prospective study of 20 patients with proximal humerus fracture treated by percutaneous pinning with K-wires from June 2019 to June 2021 were clinically and radio graphically analysed. Functional assessment of final results are noted using Neers scoring system.
Results: According to Neers score 5 had excellent results (25%), 11 had satisfactory results (55%), 3 had unsatisfactory (15%) and 1 patient had failure (5%).
Conclusion: From the present study it is concluded that the treatment of proximal humerus fracture is closed reduction with percutaneous pinning with K wire fixation, as it is least time consuming, biological fixation, easy to operate, less soft tissue damage with good functional outcome.

Background: The proximal humerus fractures are not easy to handle and are the second most
common fractures of the upper extremity. The aim of the study is to analyze the treatment
outcome of proximal humerus fractures using Philos Plate.
Methods: The present study included 40 patients from May 2019 to May 2021 who
underwent PHILOS plate fixation for displaced proximal humeral fractures using the
PHILOS plating system in the department of Orthopaedics, IGIMS, Patna.
Results: Patients were followed up for 6 to 18 months. The mean Constant shoulder score
was 75 (range 28–88). 14 patients had a score exceeding 75,11were scored between 50 and
75, and 10 were below50. Constant scores in 2-, 3- and 4-part fractures were compared.
Conclusion: In the present study, PHILOS plate fixation provided stable fixation with
minimal metal work problems and enabled early range-of-motion exercises to achieve
acceptable functional results. However, the choice of treatment should be based on patient
age, functional requirements, bone quality and fracture pattern.