Publication:

An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

Background Fractures of the proximal humerus are complex injuries associated with significant morbidity. Various options are available for management including non-operative treatment, depending upon the pattern of the fracture, quality of the bone and the surgeon's familiarity with the techniques. The age of the patient, physical activity and the medical fitness also largely influence the treatment options. The aim of this study was to evaluate the functional outcome following surgical management of these fractures and to compare the results with studies as available in literature.

Methods 30 patients with fractures of the proximal humerus managed by surgical means were studied from January 2012 to January 2014 and were followed up for a minimum period of two years.

Results All the fractures treated united clinically by 8 weeks and radiologically by 16 weeks. There were no cases of delayed or non-union in our series. The fractures were more common in men with a gender distribution of 1.3:1 and were also more common in the age group of 50 to 65 years (53%). As per the Neer’s scoring system, 60% patients had excellent results while 33% patients had satisfactory results. They were all pain free and successfully returned to their pre-injury work. 6% patients had an unsatisfactory result.

Conclusions Surgical management of proximal humerus fractures following the principles of articular surface reconstruction, restoration of the anatomy, stable fixation, with minimal injury to the soft tissues and early mobilization, gives good functional results.