Short and medium term functional outcome of hemi-replacement in complex proximal humerus fracture
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20202049Keywords:
Proximal humerus fracture, Complex fractures, Hemi replacement arthroplasty, Functional outcomeAbstract
Background: Complex proximal humerus fractures are common injuries are common just because of high incidence of road traffic accidents and old age population. The aim of this study was to evaluate the functional outcome in hemi-replacement in complex 3and 4 part of proximal humerus fracture.
Methods: This prospective study was conducted in the Department of Orthopaedics, Sir. T. Hospital, Bhavnagar from August 2010 to April 2014. Out of 30 patients 27 turned up for follow up 3 was lost. Functional and clinical assessments using the age and gender specific Constant-Murley score.
Results: Excellent to good outcome as per Constant-Murley score was seen in 16 patients, moderate outcome in 8 patients and poor outcome in 3 patients.
Conclusions: To spare proximal humerus in younger patients there should be do osteosynthesis procedure with every effort. In the elderly, especially with more complex four-part fractures and fracture dislocations, hemiarthroplasty and reverse total shoulder arthroplasty are specified to decrease complication rates and improve functional outcomes.
References
Green A, Norris T. Part II: Proximal humeral fractures and fracture dislocations. In: Browner BD, Jupiter JB, Levine AM, Trafton PG, eds. Skeletal Trauma: Basic Science, Management, and Reconst-ruction. 2nd ed. Philadelphia, PA: Saunders; 2002.
Agarwal A, Rana A, Sharma RK. Functional outcome after primary hemiarthroplasty in three or four parts proximal humerus fracture: A short term follow up. Indian J Orthop. 2016;50(6):590-4.
Lanting B, Dermid MJ, Drosdowech D, Faber KJ. Proximal humeral fractures: A systematic review of treatment modalities. J Shoulder Elbow Surg. 2008;17:42-54.
Thyagarajan DS, Haridas SJ, Jones D, Dent C, Evans R, Williams R. Functional outcome following proximal humeral interlocking system plating for displaced proximal humeral fractures. Int J Shoulder Surg. 2009;3(3):57-62.
Iannotti JP, Ramsey ML, Williams GR, Warner JJ. Non-prosthetic management of proximal humeral fractures. Instr Course Lect. 2004;53:403-16.
Chambers L, Dines JS, Lorich DG, Dines DM. Hemiarthroplasty for proximal humerus fractures. Curr Rev Musculoskelet Med. 2013;6(1):57-62.
Constant CR. Cork: MCH Thesis, University College; 1986. Age related recovery of shoulder function after injury.
Neer CS. Displaced proximal humeral fractures II. Treatment of three parts and four parts displacement. J Bone Joint Surg Am. 1970;52:1090-103.
Cadet ER, Ahmad CS. Hemiarthroplasty for three- and four-part proximal humerus fractures. J Am Acad Orthop Surg. 2012;20:17-27.
Koukakis A, Apostolou CD, Taneja T, Korres DS, Amini A. Fixation of proximal humeral fractures using the PHILOS plate: Early Experience. Clin Orthop Relat Res. 2006;442:115-20.
Gerber C, Werner CM, Vienne P. Internal fixation of complex fractures of the proximal humerus. J Bone Joint Surg Br. 2004;86(6):848-55.
Spross C, Platz A, Rufibach K, Lattmann T, Forberger J, Dietrich M. The PHILOS plate for proximal humeral fractures - risk factors for complications at one year. J Trauma Acute Care Surg. 2012;72(3):783-92.
