E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya.

Abstract
Background: Fractures of the proximal humerus, which account for 4% to 5 % of the total fractures,[1] are usually classified as per Neer’s classification. These fractures are treated by modalities from “just a sling” to “open reduction and internal fixation”(ORIF) by locking contoured dedicated plates for the proximal humerus, with results varying from satisfactory to good.

Objective: To propose a minimally invasive technique, of managing fractures of the proximal humerus, which can be done under local anesthesia.

Materials and Methods: Sometimes, patients with the proximal humerus fractures are not fit for general anesthesia. Moreover, the regional block may or may not always work for shoulders; hence, we operated 18 patients and fixed the fractures with the Joshi’s External Stabilization System (JESS) under local anesthesia.

Result: Of the 18 patients, all of them tolerated the procedure well except three of them, whom we supplemented with intravenous tramadol as well. While the stability with “K-wires” and “just screws” is questionable, ORIF entails a big exposure and blood loss, along with all other risks of open reduction. Moreover, all these techniques offer a debatable quality of fixation in osteoporotic fractures.

Conclusion: To combat the aforesaid issues, external fixation is in popularity for a period more than a decade now. The JESS, happens to be “today’s best option,” which we attempted performing under local anesthesia.

Key words: JESS, proximal humerus fractures, ORIF (open reduction internal fixation), K-wire, local anesthesia


 
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REFERENCES
1. Handoll HH, Gibson JN, Madhok R. Interventions for treating proximal humeral fractures in adults. Cochrane Database Syst Rev 2003;4:CD000434. [DOI via Crossref]   
2. Kumar R, Gupta A, Sharma VP, Mishra S. Strength of the Joshi External Stabilising System. J Orthop Surg (Hong Kong) 2011;19(1):72-5.
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4. Monga P, Verma R, Sharma VK. Closed reduction and external fixation for displaced proximal humeral fractures. J Orthop Surg (Hong Kong) 2009;17(2):142-5.
5. Kristiansen B, Kofoed H. External fixation of displaced fractures of the proximal humerus. Technique and preliminary results. J Bone Joint Surg Br 1987;69-B(4):643-6.
6. Vallier HA. Treatment of proximal humerus fractures. J Orthop Trauma 2007;21(7):469-76. [DOI via Crossref]    [Pubmed]   

How to Cite this Article
Pubmed Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya. JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures. Int J Med Sci Public Health. 2016; 5(4): 647-650. doi:10.5455/ijmsph.2016.0508201597


Web Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya. JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures. http://www.ijmsph.com/?mno=198593 [Access: December 10, 2018]. doi:10.5455/ijmsph.2016.0508201597


AMA (American Medical Association) Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya. JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures. Int J Med Sci Public Health. 2016; 5(4): 647-650. doi:10.5455/ijmsph.2016.0508201597



Vancouver/ICMJE Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya. JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures. Int J Med Sci Public Health. (2016), [cited December 10, 2018]; 5(4): 647-650. doi:10.5455/ijmsph.2016.0508201597



Harvard Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya (2016) JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures. Int J Med Sci Public Health, 5 (4), 647-650. doi:10.5455/ijmsph.2016.0508201597



Turabian Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya. 2016. JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures. International Journal of Medical Science and Public Health, 5 (4), 647-650. doi:10.5455/ijmsph.2016.0508201597



Chicago Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya. "JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures." International Journal of Medical Science and Public Health 5 (2016), 647-650. doi:10.5455/ijmsph.2016.0508201597



MLA (The Modern Language Association) Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya. "JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures." International Journal of Medical Science and Public Health 5.4 (2016), 647-650. Print. doi:10.5455/ijmsph.2016.0508201597



APA (American Psychological Association) Style

Abhay Manchanda, Satya Narayan Shukla, Abhilash Shishodiya, Vineet Kumar Gohiya (2016) JESS under local anesthesia: a minimally invasive technique for proximal humeral fractures. International Journal of Medical Science and Public Health, 5 (4), 647-650. doi:10.5455/ijmsph.2016.0508201597





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