Document Type : Research Article
Abstract
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
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