Functional Outcome and Complications in Management of Proximal Humerus Fractures Operated with Proximal Humerus Locking Plate

@#Introduction: Controversies exist in treatment of proximal humerus fractures as treatment options vary greatly from conservative management, closed pinning, stacked intramedullary nails, plating and hemi-arthroplasty. The purpose of this study is to study the fracture patterns of each case and document the functional outcome and complications post-operative in the management of proximal humerus fractures operated with proximal humerus plate. Materials and Methods: Thirty five patients with closed proximal humerus fractures, above 18 years old, admitted in our tertiary care hospital during the study period were enrolled. Patients underwent open reduction internal fixation with proximal humerus locking plate under general anaesthesia. Post-operative patients were assessed using Constant and DASH scores. Complications were recorded. Results: In our study the absolute Constant score of the study population increases at three months and six months and was found to be significant. Mean Constant score for 4- part fractures was 45.6 which were inferior as compared to 2-part and 3-part fractures (43.1 and 44.6, respectively). The mean Constant score at six months was 51.80 +/- 6.71. All three types of proximal humerus fractures showed significant improvement in the mean DASH score over our study period of six months and was found to be significant. Mean DASH score at six months was 27.97+/-12.84. Out of the 35 cases in the study two had complications. One had implant failure (Neer’s type 3, 60-year-old female) and one had varus collapse (Neer’s type 3, 45-year-old male). Conclusion: Due to angular stability and effective maintenance of the intraoperative fracture reduction during follow-up period, early post-operative mobilisation is possible which helps the patient to attain better shoulder range of motion and return to activity faster.

Perceptions & practices of diabetics in Pondicherry.

The knowledge, attitude and self care regarding diabetes was assessed in 150 diabetics, residing in Pondicherry, using a pre-tested schedule addressing six areas of diabetic self-care. Observations made included the ability of the patients to test, interpret and record the result of urine examination; diet practices; and insulin use. The knowledge, attitude and practices of diabetics were less than satisfactory in all the areas of self-care. Up to 80 per cent had a complication or associated disease. Most of the patients appreciated the need for dietary care or medication, but only 50 per cent regulated their diet. Of the 97 per cent using anti-diabetic agents, some were using them harmfully. Only 10.6 per cent of the patients tested their urine, though 71 per cent were aware of the need for this. Only 34 per cent saw a physician regularly. None of the patients had any formal education regarding diabetes.