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Outcome of plate osteosynthesis in the management of proximal humeral fractures in adults
Abstract
Background: This paper reports the aetiology, presentation and management of proximal humeral fractures (PHF) in our setup.
Objective: To share our experiences with this relatively uncommon injury. The secondary objective is : to assess the functional outcome of plate osteosynthesis in management of displaced proximal humerus fractures (displacement of> 5mm or/ and angulation of > 45°).
Design: This was a retrospective analytical study between January 2000 and December 2009.
Setting: The study was done at The Mombasa Hospital, Mombasa, Kenya.
Subjects: All skeletally mature patients with fractures of proximal humerus that were seen and managed by the author between January 2000 and December 2009 were included in the study. Three patients who had pathological fractures from tumour and infection were excluded from the study.
Results: Forty two out of 1454 fractures (2·9%) were seen and managed for PHF during the study period. Twenty four were males and 18 females (M: F ratio = 4:3). Their ages ranged from 24 years to 85 years with a mean age of 54 years. However, the male mean age was 48 and 60 years for the females in the study. The commonest cause of injury was a fall (71%) followed by motor vehicle accident (MVA) (17%). Thirty one fractures (74%) were a two-part fracture. Thirty two fractures (74%) were treated by plate osteosynthesis out of which 25 (75%) made satisfactory recovery. Five of thirty two operated cases (15%) developed significant shoulder joint stiffness. Shoulder arthroplasty was unavailable.
Conclusion: Plate osteosynthesis is an effective method of treatment of selected patients with PHF. There is need for arthroplasty in those with severe injury, particularly those with osteoporosis.
East African Orthopaedic Journal, Vol. 4: September 2010
Objective: To share our experiences with this relatively uncommon injury. The secondary objective is : to assess the functional outcome of plate osteosynthesis in management of displaced proximal humerus fractures (displacement of> 5mm or/ and angulation of > 45°).
Design: This was a retrospective analytical study between January 2000 and December 2009.
Setting: The study was done at The Mombasa Hospital, Mombasa, Kenya.
Subjects: All skeletally mature patients with fractures of proximal humerus that were seen and managed by the author between January 2000 and December 2009 were included in the study. Three patients who had pathological fractures from tumour and infection were excluded from the study.
Results: Forty two out of 1454 fractures (2·9%) were seen and managed for PHF during the study period. Twenty four were males and 18 females (M: F ratio = 4:3). Their ages ranged from 24 years to 85 years with a mean age of 54 years. However, the male mean age was 48 and 60 years for the females in the study. The commonest cause of injury was a fall (71%) followed by motor vehicle accident (MVA) (17%). Thirty one fractures (74%) were a two-part fracture. Thirty two fractures (74%) were treated by plate osteosynthesis out of which 25 (75%) made satisfactory recovery. Five of thirty two operated cases (15%) developed significant shoulder joint stiffness. Shoulder arthroplasty was unavailable.
Conclusion: Plate osteosynthesis is an effective method of treatment of selected patients with PHF. There is need for arthroplasty in those with severe injury, particularly those with osteoporosis.
East African Orthopaedic Journal, Vol. 4: September 2010
