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Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

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Radiological and Functional Outcomes of Joshi External Stabilization System (JESS) in Proximal Humerus Fractures: A

Siddhartha Sinha¹, Sandeep Kumar¹, Arvind Kumar²

¹Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India.

Indian Journal of Orthopaedics

|May 5, 2025

Summary

The Joshi External Stabilization system (JESS) shows promise for treating proximal humerus fractures, offering good to excellent functional outcomes. While effective, common complications include pin tract infections and loosening.

Keywords:

Humerus external fixation Humerus fractures JESS fixator Joshi external stabilization system Proximal humerus fixation Proximal humerus fractures Proximal humerus trauma

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Area of Science:

Orthopaedic Surgery
Traumatology

Background:

External fixation is gaining traction for proximal humerus fractures due to benefits like reduced blood loss and ease of application.
The Joshi External Stabilization system (JESS) presents a novel approach to managing these complex fractures.

Purpose of the Study:

To evaluate the radiological and functional outcomes of proximal humerus fractures treated with the JESS.
To assess the efficacy and safety of the JESS in a clinical setting.

Main Methods:

A retrospective case series involving 28 patients (age >18) with proximal humerus fractures treated with JESS.
Data collected from January 2020 to January 2024, including fracture type, follow-up assessments, and complication rates.

Main Results:

The majority of fractures (Neer's type 3) united by 6 weeks.
At 24 weeks, 75% of patients achieved good and 25% excellent Constant scores.
The overall complication rate was 28.6%, with superficial pin tract infections and fixator loosening being most common.

Conclusions:

The JESS is a viable treatment option for proximal humeral fractures, particularly in the geriatric population.
Surgeons should be aware of inherent complications such as pin tract infections and loosening associated with JESS.
Further research may explore optimizing JESS application to minimize complications.