Treatment of Three-and Four-Part Proximal Humerus Fractures by MultiLoc Nailing Technique- A Prospective Study RC09-RC11
Dr. Gaurav Mahesh Sharma,
Clinical Associate, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai-400004, Maharashtra, India.
Introduction: Proximal humerus fractures are third most common fractures with lack of proper consensus for treatment, especially in three-and four-part fractures. With the advent of Multiloc technique, the advantages of nailing can be successfully applied to the proximal humerus fractures.
Aim: To assess the functional and radiological outcome in three-and four-part fractures treated with Multiloc nailing.
Materials and Methods: A prospective study patients over a period of two years between December 2013 and February 2015 was conducted on 21 patients with proximal humerus fracture treated with Multiloc nailing system. Patients with three-and four-part fractures above 60 years were included in the study and regular follow-ups were done till the end of two years.
Results: The most common mechanism of injury was fall comprising of 15 (71.4%) cases followed by Road Traffic Accident (RTA) with six (28.6%) cases. As per Neer’s classification, 13 (61.9%) cases had three-part and eight (38.1%) cases had four-part fracture respectively. Mean operative time was 112±8.6 minutes. The average duration of hospital stay was 4.6±1.3 days. Radiological union was seen at 13±2.6 weeks. There was one (4.7%) case with varus collapse. Two (9.5%) cases had shoulder impingement in the present study. The mean Constant shoulder score was 61±12.4. The final outcome was measured using the Constant scoring system. There were 8 (38.2%) excellent, 9 (42.9%) good, 2(9.5%) satisfactory, 1 (4.7%) fair and 1 (4.7%) poor case respectively.
Conclusion: MultiLoc nailing is a good angular stable device which gives a secure fixation in communited three-and four-part fractures especially in osteoporotic bones.