Categories

Volume 5 Issue 1 (January, 2017)

Original Articles

DISPLACED FRACTURES OF GREATER TUBEROSITY OF HUMERUS- OUTCOMES AND COMPLICATIONS AFTER OPEN REDUCTION AND INTERNAL FIXATION
R.K. Mishra

Background: Humerus fractures account for 5% to 8% of total fractures. Non-union and delayed union of Greater Tuberosity (GT) fractures though uncommon but presents a challenge to the orthopedic surgeons. Substantial disagreement surrounds ideal treatment of such neglected fractures. This article evaluates the outcomes of open reduction and internal fixation (ORIF) of displaced GT fractures. Methods: Results of surgical intervention in 15 patients with displaced non union of GT fractures were evaluated. Range of Motion, muscle forces, Visual Analogue Scale (VAS) and Activities of Daily Living (ADL) Score were all recorded preoperatively and after 30 months of follow up post-surgery. The results obtained were compared with that of the undamaged shoulder. Results: Patients undergoing surgical intervention were followed up for 24.5 months on an average. All fractures healed satisfactorily. Anatomic reduction could be achieved only in 8 cases with no reports of necrosis or infection. Range of motions and muscle forces were found to have increased significantly [Mean Forward Flexion: 58.22 to 149.6(ROM), Mean Internal Rotation: 2.8 to 4.4(muscle force), Mean External Rotation: 4.4 to 4.7(muscle force)] (p<0.0001). VAS and ADL scores also improved significantly postoperatively (Mean VAS: 6.8 to 1.1, Mean ADL: 6.2 to 28.3) (p<0.0001). Conclusion: Even for displaced fractures of the Greater Tuberosity, open reduction and internal fixation has satisfactory functional outcomes, despite non-anatomical reduction of the fracture.
Keywords: Delayed union, Greater tuberosity, Humerus fractures, Reduction

 
Html View | Download PDF | Current Issue