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Proximal Humerus Fractures: Non-Operative Management V/S Closed Operative (K-Wire/Rush Pin Fixation)

Humerus injuries need to be evaluated early so that the fracture can be easily classified and you are in the know of when to contact the orthopaedic for consultation. Most of these Humerus fractures are minimally displaced or even non displaced, thus it is easy to manage these non operatively. The portion which involves the glenohumeral articulation is termed as the ‘proximal humerus’. The treatment for this has always posed a challenge for the surgeons as there are multiple factors to be considered before the treatment can be planned. The assessment of the fracture needs to be accurate besides the patient’s compliance needs to be taken into consideration. You also need to consider the medical comorbidities and the time taken for the treatment. Besides this, you need to make sure of the experience of the surgeon.

Non-operative treatment for Humerus Fractures

Being able to manage these fractures without any operation may require the need for immobilisation in the patient for a certain amount of time, which is then followed by an early motion. This immobilization can be achieved by using a shoulder sling or a sling which has a swathe. As the patient’s axilla is apposed for a long period of time, placing a simple pad in the axilla can minimize chafing of the skin. The exercises required to speed up the healing process can start after a period of 7 to 10 days in case the fracture is stable. In case the orthopaedic surgeon feels the fracture to be unstable, you might need to go for an operation. It is only after 3 weeks that physical therapy is advised.

Closed Operative (K-Wire/Rush Pin Fixation)

Operating a patient with proximal humerus fractures using the K-wire is able to achieve a intramedullary fixation of the closed kind of the fractures. The operations are performed using general anesthesia. These wires can be removed after a period of 5 months without any complications being involved. This is an easy, simple reliable and a safe procedure which can be followed for humerus fractures. This can be an economical procedure and the patient gets the required relief early. In recent times, you find that methods that involve fixation to the minimum with dissection being limited are fast gaining popularity. You should be aware that these fractures can cause a devastating effect on the quality of life and probably, loss of productivity from the members of a workforce.

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