Assessment of Functional and Radiological Outcome in Patients of Proximal Humerus Fractures Managed by Proximal Humerus Locking Compression Plate - A Longitudinal Observational Study from Moradabad, Uttar Pradesh

BACKGROUND The proximal humerus fractures are mostly undisplaced fractures. Various complications which were encountered with the closed treatment included: subacromial impingement, malunion, shoulder pain, avascular necrosis, stiffness secondary to osteoarthritis and the rotator cuff deficiency. In order to overcome these complications, trend has shifted towards surgical management. The present study was conducted to assess the functional and radiological outcome in patients with proximal humerus fracture managed by proximal humerus locking compression plate. METHODS This was a longitudinal observational study (combination of retrospective and prospective design) conducted in the Department of Orthopaedics in Teerthanker Mahaveer Medical College and Research Centre, Moradabad. All patients with proximal humerus fractures under Neer’s classification who fulfilled our inclusion criteria were included. The radiological assessment was done by union, complication or any failure on x-ray and functional outcome was assessed by University of California at Los Angeles (UCLA) score. Surgery was performed under general/brachial anaesthesia in beach chair position. Delto-pectoral approach was used. Injectable antibiotics (3 rd generation cephalosporin) and analgesic (paracetamol/tramadol) were given for 3 days after surgery. Post op. X- ray of shoulder with arm antero-posterior and lateral view were taken on 2nd day of surgery RESULTS A total of 34 patients were included in the study who were followed up for a minimum of one year. At the end of the follow up, 25 patients showed union except for 3 non-union, 1 delayed union, 2 valgus and 2 varus deformity, 2 avascular necrosis (AVN) and 2 infections. The functional outcomes were excellent in 5 patients, good in 14 patients, fair in 9 patients and poor in 6 patients. CONCLUSIONS Proximal humerus locking compression plate is a safe and effective procedure for the management of proximal humerus fracture for young as well as older age group individuals with good functional outcome. The complications are acceptable and can occur in any hospital with any experienced surgeon. KEYWORDS Proximal Humerus, Fracture, Compression Plate