Outcome assessment of proximal humerus fractures management using locking compression plate (LCP)
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 7, Pages 4841-4848
AbstractBackground: Proximal humerus fractures account for 4% of all fractures. Most proximal humerus fractures can be managed conservatively, but 3-part and 4-part fractures are unstable and need internal fixation.
Aim: The aim of the present study was to evaluate the clinical and functional outcome of proximal humerus fractures treated with locking compression plate (LCP) in adults.
Materials and Methods: This prospective observational study was carried out in the Department of Orthopaedics, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India, for 12 months. Total 50 patients were included in this study. All cases of closed proximal humeral fractures (Closed two-part fracture with humeral diaphyseal extension or three or four-part fracture having a tuberosity displacement enough to cause a significant sub-acromial impingement). Constant-Murley scoring (100 point scoring system) assessment includes subjective complaints and clinical signs The subjective complaints assessed were Pain (15 points) and activities of daily living (20 points). The clinical signs assessed were range of motion (40 points) and power based on MRC grading (25 points).
Results: Motor vehicle accidents in 35 patients, fall from height (14 patients) and electic shock (1 patient) are major causes. At the end of one year, 17 patients (34%) had excellent outcome, 25 patients (50%) were functionally good and 7 patients (14%) had scores between 56-70, which according to the literature is a fair result. 1 patient (2%) had scores less than 55 points and were graded poor. The mean Constant-Murley shoulder score was 82.91, thereby falling in the good outcome category. The average outcome after 1 year follow-up as per Neer’s classification shows excellent outcome for two part fracture (mean constant score = 85.23). While three part Fractures have average outcome.
Conclusion: The proximal humeral locking plate seems to be an adequate device for the fixation of displaced proximal humerus fractures as 84% of our study population had excellent/good functional outcomes.
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