Treatment of Three-and Four-Part Proximal Humerus Fractures by MultiLoc Nailing Technique- A Prospective Study
Published: November 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/30973.10875
Gaurav Mahesh Sharma, Lokesh Gudda Naik, Waghchoure Chaitanya, Sushant Chavan, Kunal Roy, Prashant Pawar, Akshay Bhardwaj, kalyantadepalli
1. Clinical Associate, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.
2. Clinical Associate, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.
3. Clinical Associate, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.
4. Clinical Associate, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.
5. Clinical Associate, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.
6. Resident, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.
7. Senior Resident, Department of Orthopaedics, Lokmanya Hospital, Pune, Maharashtra, India.
8. Resident, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.
Correspondence
Dr. Gaurav Mahesh Sharma,
Clinical Associate, Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai-400004, Maharashtra, India.
E-mail: sharmagaurav@live.com
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.
[
FULL TEXT ] | [ PDF]