Outcome of comminuted proximal humerus fracture treatment with locking compression plate. 2013

Krzysztof Piątkowski, and Krzysztof Kwiatkowski, and Piotr Piekarczyk, and Mateusz Przybycień, and Damian Zaborowski

BACKGROUND Therapeutic management of proximal humerus fractures is still controversial. There are several ways of proceeding in these cases, ranging from conservative treatment to shoulder joint arthroplasty. Open surgical reduction and stabilization with a locking compression plate is currently the most widely used method of treatment, especially in younger patients. The purpose of this study is to analyze the results of surgical treatment of fractures of the proximal humerus using locking compression plates. METHODS The study included 69 patients, 57 of them reported for the follow-up (82.6% of respondents). Clinical and radiological evaluation was performed at 6 weeks and 6 months following the surgery. Functional outcome was assessed using the Constant score. We also evaluated shoulder flexion active range of motion. Bone union and common complications were evaluated on the basis of radiographs--humeral head necrosis and the evidence of loosening of the bone-binding material. RESULTS The mean Constant score was 68.9 points and 75.94% relative to the opposite limb (relative mean score). No bone healing was observed in 7% (4 of 57) patients. There was a total of 21% (12 of 57) cases of humeral head necrosis. These changes varied in nature, location and severity. In 2 cases, reoperation was required due to loosening of the bone-binding material. Shoulder flexion active range of motion averaged 132 degrees and was lower in cases of 4-part fractures. CONCLUSIONS Surgical treatment of stable 3-part fractures of the proximal humerus using locking compression plate should be the treatment of choice in younger patients. Given the poor results, the choice of treatment involving 4-part fractures should be individually tailored.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001860 Bone Plates Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999) Bone Plate,Plate, Bone,Plates, Bone
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old

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