JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures
Journal Title: International Journal of Medical Science and Public Health - Year 2016, Vol 5, Issue 4
Abstract
Background: Fractures of the proximal humerus, which account for 4% to 5 % of the total fractures,[1] are usually classified as per Neer’s classification. These fractures are treated by modalities from “just a sling” to “open reduction and internal fixation”(ORIF) by locking contoured dedicated plates for the proximal humerus, with results varying from satisfactory to good. Objective: To propose a minimally invasive technique, of managing fractures of the proximal humerus, which can be done under local anesthesia. Materials and Methods: Sometimes, patients with the proximal humerus fractures are not fit for general anesthesia. Moreover, the regional block may or may not always work for shoulders; hence, we operated 18 patients and fixed the fractures with the Joshi’s External Stabilization System (JESS) under local anesthesia. Result: Of the 18 patients, all of them tolerated the procedure well except three of them, whom we supplemented with intravenous tramadol as well. While the stability with “K-wires” and “just screws” is questionable,[2] ORIF entails a big exposure and blood loss, along with all other risks of open reduction.[3] Moreover, all these techniques offer a debatable quality of fixation in osteoporotic fractures.[4] Conclusion: To combat the aforesaid issues, external fixation is in popularity for a period more than a decade now. The JESS, happens to be “today’s best option,” which we attempted performing under local anesthesia.
Authors and Affiliations
Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya
Keywords
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- EP ID EP117825
- DOI 10.5455/ijmsph.2016.0508201597
- Views 93
- Downloads 0
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