Outcomes of Open Reduction and Internal Fixation of Proximal Humerus Fracture Dislocations

Abstract Introduction Proximal humeral fracture with associated glenohumeral dislocation (PHFD) is a challenging clinical problem. Outcomes of open reduction, and internal fixation (ORIF) of these injuries has not been widely reported. The purpose of this analysis is to report our experience with ORIF of PHFD. Methods Retrospective review of our two institutions’ shoulder surgery databases was conducted to identify all PHFDs that were treated with ORIF from 2008 through 2017. Radiographs were reviewed for fracture healing by twelve weeks postoperatively. All reoperations were recorded. Patient-reported outcomes Simple Shoulder Test [SST] and American Shoulder and Elbow Surgeons [ASES] score at minimum two-year follow-up were recorded. Results There were twenty PHFDs identified: they were 50% male, 55.8±10.3-years-old (range 31.3-66.3), and BMI 29.3±8.2 (15.2-47.8). Seven (35%) patients experienced varus collapse, nonunion, or avascular necrosis and six (30%) patients underwent reoperation. Of the 17 patients that did not go onto revision or arthroplasty, 14 (82.3%) had patient-reported outcomes at 4.9±2.2 years (2.3-8.8) follow-up. These patients had an average SST 8.0±4.0 yes responses (0-12) and ASES of 71.6±20.4 (20.2-94.9). Conclusion ORIF of PHFD carries a high rate of reoperation. In patients who achieve healing, functional scores are satisfactory. This information is important for proper patient counseling prior to surgery.