Abstract :
Aim: To evaluate the outcome of open reduction and internal fixation using locking compression plate for proximal humeral fractures, done at a tertiary care referral teaching super specialty hospital in Andhra Pradesh, India from 1st may 2015 to 31st may 2017.
Materials and Methods: The study consists of 53 patients diagnosed with proximal humerus fractures which were treated by open reduction and internal fixation with locking compression plate in a week after trauma, with in the age group of 20-60 years were selected. All patients were preoperatively evaluated with
radiographs and CT 3D reconstructions. Post operatively their prognosis assessed by 100 point Constant- Murley scoring system. After attrition, to loss of follow-up, 49 patients followed for minimum 1 year. Their results were analyzed including complications.
Results: At the end of one year, sixteen patients (32.65%) had excellent outcome with scores between 86- 100, twenty five patients (51.02%) were functionally good with scores between 70 and 85. Seven patients (14.28%) had scores between 56 and 70, which according to the literature is a fair result. One patient (2.04%) had scores less than 55 points and was graded poor. The Mean Constant-Murley shoulder score was 82.85, thereby falling in the good outcome category.
Conclusion: The Proximal humerus Locking Compression plating (LCP) technique gives moderate to excellent results in cases with proximal humerus fractures, depending on the fracture pattern. Those who were treated with early fixation and early mobilization were found to have a better functional outcome irrespective of the fracture type. Good surgical results can only be obtained by vigorous physiotherapy imparted by an expert team and strong motivation from the patient side. The results obtained with using Locking Compression Plates (LCP) were comparable to Proximal Humerus InterLocking System (PHILOS) plates except for varus collapse being common complication while using former for internal fixation.
Keyword :
Proximal humerus fracture, Locking compression plate, Constant murley score internal fixation