title: Regional anesthesia improves outcome in patients undergoing proximal humerus fracture repair.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Egol
authors.forename: Jordanna
authors.initials: J
authors.lastname: Forman
authors.forename: Crispin
authors.initials: C
authors.lastname: Ong
authors.forename: Andrew
authors.initials: A
authors.lastname: Rosenberg
authors.forename: Raj
authors.initials: R
authors.lastname: Karia
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Zuckerman
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D065527:Brachial Plexus Block / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012784:Shoulder Fractures / Q000175:diagnosis / Q000601:surgery; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D016896:Treatment Outcome