Regional anesthesia improves outcome in patients undergoing proximal humerus fracture repair

• Published in: Bulletin of the NYU Hospital for Joint Diseases Vol. 72; no. 3; p. 231
• Main Authors: Egol, Kenneth A, Forman, Jordanna, Ong, Crispin, Rosenberg, Andrew, Karia, Raj, Zuckerman, Joseph D
• Format: Journal Article
• Language: English
• Published: New York J. Michael Ryan Publishing Co 01.07.2014; J. Michael Ryan Publishing, Inc
• Subjects: Fracture fixation; Health aspects; Methods; Patient outcomes; Regional anesthesia
• ISSN: 1936-9719; 1936-9727

Background: The purpose of this study was to examine functional outcomes following ORIF of displaced proximal humerus fractures in patients who received brachial plexus blocks compared to those who underwent general anesthesia. Methods: We retrospectively reviewed prospectively collected data on 92 patients. Patients were grouped according to anesthesia type: regional interscalene brachial plexus block, with or without general anesthesia, or general anesthesia alone. Patients were asked to complete the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and range of motion assessments at a minimum of 6-month follow-up. Plain radiographic films were obtained to assess fracture healing. Results: Forty-five (48.9%) patients with 45 proximal humerus fractures received a regional anesthetic, while 47 (51.1%) patients with 48 proximal humerus fractures had general anesthesia. No significant differences existed in demographic information or fracture type. DASH scores at the most recent follow-up were significantly better in the regional block group (38.6) compared to the general anesthesia group (53.1) (p = 0.003). The regional block group had significantly better passive and active forward elevation and external rotation range and equivalent internal rotation (p = 0.002, 0.005, 0.002, and 0.507, respectively). Conclusion: Patients who received regional anesthetic via a brachial plexus interscalene blocks had better functional outcomes and range of motion at the most recent clinical follow-up. Regional anesthesia provides patients with prolonged postoperative pain relief, which may allow for early mobilization, increasing the likelihood that the patient's function and range of motion will return to baseline.