ABSTRACT
Fractures around proximal humerus are common injuries occurring in predominantly elderly female population associated with osteoporosis. Elderly age group associated with comorbidity gives good outcome with minimal intervention with external stabilization of the fracture avoiding major surgical procedure on proximal humerus. Objective:to study the outcomes of fixation of proximal humerus fracture by external stabilizing system in elderly, osteoporotic and comorbid patients. Methodology:we did study of 30 Neers type 3 and type 4 fracture patients in span of 12 months from fracture in which 17 were female and 13 were male patients. The age group was 50 to 75. The results external fixation of fracture was evaluated as per Neers criteria. Results:all 30 patients were followed till fracture got union. In Neers type 3 fracture 13 (81.25%) patients got good results while in type 4 fractures 09 (64.28%) patients got good results. Conclusion: external stabilization of Neers type 3 and 4 proximal humerus fracture patients who are elderly, osteoporotic and comorbid shows excellent outcome with this minimally invasive stabilizing system.
ABSTRACT
For inter trochanteric fracture Proximal Femoral Nail (PFN) is a better choice of implant biomechanically. But in communicated inter trochanteric fractures it is associated with screw breakage, cut out through femoral head, ”Z” & reverse “Z” effect and lateral migration of screws. The purpose of this study is to evaluate the results of PFN in terms of post-operative complication and failure rates in unstable trochanteric fracture with addition of 1 or 2 tension band wires. Material & Method:We did study of 21 unstable trochanteric fractures from January 2016 to November .2020. 14 patients were males & 7 patients were females. Age group between 25 to 80 was included in this group. There were 15 A0 A2 (2.2, 2.3) and 6 were A0 A3 (3.1, 3.2, 3.3). All fractures were ?xed with 25cm, 0135PFN mainly 11 mm, 12mm in diameter with addition of one or two 16 gauge tension band wire, strengthening lateral trochanteric wall and holding either communiated fragments or lesser trochanteric fracture. Results:The fracture was united in all cases with mean period of 16 weeks. Two patients developed complication of TBW (Tension Band Wire) breakage; one developed lateral migration of screws. Patients were followed till bone was united. At the end of follow up hip function were 30 (out of 40) in 80% patients by using Salvati and Wilson hip score. Conclusion: The stabilization of lateral trochanteric wall fracture and communiated fragments of inter trochanteric fractures, additional one or two TBW increases the stability of construct enhancing bony union & better results.