Functional Outcome of Proximal Humerus Fracture Managed Surgically by Joshi's External Stabilizing System

Authors

  • Prakriti Raj Kandel Universal College of Medical Sciences, Bhairahawa, Nepal
  • Bipan Shrestha Universal College of Medical Sciences, Bhairahawa, Nepal
  • Kishor Man Shrestha Universal College of Medical Sciences, Bhairahawa, Nepal
  • Shreshal Shrestha Universal College of Medical Sciences, Bhairahawa, Nepal
  • Pradip Chhetri Universal College of Medical Sciences, Bhairahawa, Nepal

DOI:

https://doi.org/10.3126/jucms.v9i02.41990

Keywords:

Constant Murley score, JESS, Proximal humerus fracture

Abstract

INTRODUCTION: The ideal management of proximal humerus fracture is still controversial despite various treatment options. Conservative treatment with slab is fraught with shoulder stiffness and malunion while surgical treatment with plates and nail is fraught with infection and blood loss. Therefore, Joshi External Stabilization System (JESS) being a minimally invasive percutaneous procedure can be the ideal treatment for these fractures.

MATERIAL AND METHODS: This prospective and observational hospital based study was carried out in Orthopedics Department, Universal College of Medical Sciences Teaching Hospital (UCMS-TH) from December 2018 to January 2021. All patients with traumatic proximal humerus fracture who fulfilled the inclusion criteria were enrolled in the study and were treated with JESS. Fracture was classified according to Neer classification and functional outcome was assessed according to Constant Murley Score (CMS) system. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months.

RESULTS: There was statistically significant difference in VAS score (p<0.05) measured at six weeks, three months and six months; and CMS (p<0.05) at three months and six months. There was statistically significant difference between fracture type (Neer type) and fracture union (p<0.05). But the association between functional outcome and type of fracture was statically insignificant (p>0.05).

CONCLUSION: Displaced proximal humerus fracture when treated surgically with JESS has good functional and radiological outcome. It produces less pain, less stiffness and greater Range of Motion (ROM).

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Author Biographies

Prakriti Raj Kandel, Universal College of Medical Sciences, Bhairahawa, Nepal

Department of Orthopaedics and Trauma Surgery

Bipan Shrestha, Universal College of Medical Sciences, Bhairahawa, Nepal

Department of Orthopaedics and Trauma Surgery

Kishor Man Shrestha, Universal College of Medical Sciences, Bhairahawa, Nepal

Department of Orthopaedics and Trauma Surgery

Shreshal Shrestha, Universal College of Medical Sciences, Bhairahawa, Nepal

Department of Orthopaedics and Trauma Surgery

Pradip Chhetri, Universal College of Medical Sciences, Bhairahawa, Nepal

Department of Community Medicine

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Published

2021-12-31

How to Cite

Kandel, P. R., Shrestha, B., Shrestha, K. M., Shrestha, S., & Chhetri, P. (2021). Functional Outcome of Proximal Humerus Fracture Managed Surgically by Joshi’s External Stabilizing System. Journal of Universal College of Medical Sciences, 9(02), 8–13. https://doi.org/10.3126/jucms.v9i02.41990

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Section

Original Articles