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Category: Volume 08 Issue 06 June 2020
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Title: Comparative Study on Operative and Non - Operative Treatment of Proximal Humerus Fracture in Tertiary Care Hospital

Authors: Sohan Lal, Sanjay Yadav, M K Aseri, Shanti Lal

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.23

Abstract

Background: Proximal humerus fractures are the third most common fractures after distal radius and hip fractures. Non-union rate of fractures in the proximal third of humerus and head of the femur is relatively very higher as compare to other regions with conservative treatment cases. The optimum treatment becomes more important for patient good life unlikely most of the cases they treated non operatively. Non operatively lead lots of problem and make patient’s life uncomfortable.

Objective: To compare outcomes of operative and non- operative treatment of proximal humerus fracture in tertiary care hospital.

Material and Methods: There were 100 patient who had fracture among that 50 patients are treated with non -operatively and 50 are treated with operatively.

Non-operative Treatment: Upper extremity shoulder was immobilized in a sling for 2-3 weeks with passive range of motion exercises starting after ending of 2 weeks including pendulum exercises.

Surgical Treatment: All surgeries were performed in the beach chair position and most of the case lateral deltoid split approach are using with AO reduction techniques by surgeons in upper extremity trauma. In all operations, PHILOS plates were used and after surgery, immobilization was done with a sling.

Results: In 2-Part, 3 part and 4 part fractures the ASES scores was high in operative patient than non operative patient. Similarly the VAS score was high in operative patient than non operative patient. Displacement rates were 50% of non-operative treatment where as only 10% patients X ray show displacement in operative group. The healing rate was much higher in operative group as compare to non operative group.

Conclusion: In case of the comminuted fracture in humerus the best treatment is implanting PHILOS plates which provided best ROM muscle strength and wrist grip as compare to non- operative. Non- operative comminuted fracture may lead to not proper union and lead to a prolong problem. 

Keywords: ASES, Non operative, Operative, Proximal humerus fracture, PHILOS plates, VAS.

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Corresponding Author

Sanjay Yadav

Department of Orthopaedics, Dr. S. N Medical College, Jodhpur, Rajasthan, India