To asses the functional outcome of 2-part and 3-part proximal humerus fracture treated by proximal humerus nail and percutaneous fixation

Abstract

Introduction: Fractures of the proximal humerus are relatively common injuries in adults, representing 4%-5% of all fractures presenting to the accident emergency department and approximately 5% of fractures of the appendicular skeleton. The vast majority are low-energy osteoporotic fractures with a 2-3 to 1 female to male preponderance. In the current study proximal humerus fracture 2 and 3 part, were treated by intermedullary locking nail and percutaneous fixation technique depending on the fracture pattern and assessment of the functional outcome was done so as to provide some inference regarding the suitable techniques that can be used with optimum results. Material and Methods: We received 183 patient with proximal humerus fracture in our institute from December 2017 to December 2018, out of which 43 were 2-part and 33 were 3-part, with predominance to elderly and female. Out of 76 total patients 68 (32 3-part and 36 2-part) were operated (32 -PHN and 36-percutaneous fixation). Results: In 2-part fracture both the fixation technique showed the similar radiological union time of 6 week and functional outcome of PHN (16 cases) was ASES-85.5 and CMS-79.8, and Percutaneous fixation (20 cases) mean In 3 part fixation the radiological union showed by the PHN (18 cases) was 8.6 week and the ASES -83.5 and CMS-77.8, in percutaneous fixation (14 cases) was 10.2 week and mean ASES -80.7 and CMS-78.1. Conclusion:Patient with 2-part fracture favours the fixation with percutaneous fixation given the adequate bone quality and no metaphyseal involvement, and also have the better functional outcome. In 3-part fracture the PHN has a better functional outcome and union time. The proximal humerus fracture along the factors of fracture type, is still varied on the fracture anatomy and the bone condition to decide the method of fixation.