Management of Proximal Humerus Fracture - A Case Control Prospective Study

Abstract

Objective: To study the management and functional outcome of the treatment of the fracture of neck humerus.

Material and methods: 30 cases of neck humerus fractures were managed with closed reduction with U- Slab application or closed reduction with P/C K-wire fixation to achieve reduction. ¾ Post-reduction mobilization i.e. pendulum exercises were started after 4 weeks in cases in whom reduction was good and in others it was delayed for 6-8 weeks.  The study included 57% of male patients and 43% of female patients. 57% of the fracture occurred in 50 to 80 years age group.

Results: Domestic fall accounts for 60% of the cases. ¾ According to the Neer’s classification there were two part fracture (73.33%), three- part fracture (20%) and four - part fracture (6.67%). Most of the patients managed conservatively with closed reduction with U-slab application with good reduction had excellent to satisfactory results (92.5%cases). All patients managed with percutaneous k- wires fixation (10% cases) had satisfactory results.

Biologically, the technique of closed reduction and percutaneous pinning is good from the standpoint of retaining the vascularity of the humeral head. In our study, majority of the cases had satisfactory functional results. It can be used for un-displaced or displaced two- three- or four- part fracture of the proximal humerus without communication in the younger age groups with good bone quality.

Conclusion: An adequate management technique will minimize complications and an aggressive rehabilitation regime will ensure the best possible result.