A Prospective Comparative Study of Proximal Humerus Fractures Treated Conservatively Versus Open Reduction Internal Fixation with Locking Plate
Journal Title: Journal of Bone and Joint Diseases - Year 2018, Vol 0, Issue 0
Abstract
Introduction: Proximal humerus fractures account 4-5% of all fracture and are not uncommon especially in older age groups. About 85% of fractures of proximal humerus are minimally displaced and are effectively treated by immobilization followed by early motion. Displaced proximal humerus fractures can be treated both conservatively and by open reduction internal fixation by locking compression plate for beer functional outcome. Material and Method: Over a period of 14 months 34 elderly patients of proximal humerus fractures were admitted and randomly divided into 2 groups. 18 were treated surgically and 16 conservatively. Patients treated conservatively by Shoulder Immobilizer/ Uslab/Cast. Patients who are treated surgically were taken up for open reduction and internal fixation by locking compression plate using deltopectoral approach. Patients were followed at 3wk,6wk,3month,6month, 9month and 12 month and were assessed for pain, range of motion, strength using constant and murley shoulder score. Results: In the conservative group 31.3% of the patients had poor constant scores 37.50% had moderate constant scores and 31.30% had good constant scores. While in surgical group 27.80% had poor constant score 11.10% had moderate constant scores and 61.10% had good constant scores suggesting that surgical group has beer functional outcome but in long term follow up there is not much difference other than the initial pain in the conservative group. is difference could not be proven statistically as the p value was 0.126 which is statistically insignificant. Conclusion: In this prospective comparative study, conservatively treated patients had good functional outcome with good range of movement .In elderly patients with osteoporotic bone, locking plates do well but there is no significant difference in long term follow up in the outcome of patients treated conservatively or surgically.
Authors and Affiliations
C. P. Pal C. P. Pal, Vipul Agrawal, Amrit Goyal, Vivek Mial, Abhishek Tripathi, Yajuvendra Yajuvendra
Keywords
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