Fixed-angle locking proximal humerus plate: an evaluation of functional results and implant-related outcomes

Pak, Ponnaren, Eng, Kevin and Page, Richard S. 2013, Fixed-angle locking proximal humerus plate: an evaluation of functional results and implant-related outcomes, ANZ journal of surgery, vol. 83, no. 11, pp. 878-882, doi: 10.1111/ans.12370.

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Title Fixed-angle locking proximal humerus plate: an evaluation of functional results and implant-related outcomes
Author(s) Pak, Ponnaren
Eng, Kevin
Page, Richard S.ORCID iD for Page, Richard S. orcid.org/0000-0002-2225-7144
Journal name ANZ journal of surgery
Volume number 83
Issue number 11
Start page 878
End page 882
Total pages 5
Publisher Wiley-Blackwell Publishing Asia
Place of publication Melbourne, Vic.
Publication date 2013-11
ISSN 1445-1433
1445-2197
Keyword(s) complications
locking plate
outcomes
proximal humerus fracture
Summary Background
Displaced and unstable proximal humeral fractures are challenging injuries to treat. Proximal humeral locking plates are a recent development for the treatment of these complex fractures.

Methods
Retrospective analysis of 23 patients with 23 proximal humeral fractures treated with the Synthes locking proximal humerus plate. These were Neer two-, three- and four-part fractures. Follow-up was at a mean of 22 months and included clinical assessment using the Constant score (CS) and the Short Form-12 health questionnaire. Radiographic assessment was performed to assess implant-related complication in relation to the initial fracture pattern and the presence of adequate medial support.

Results
The mean CS for all patients was 60.4 (range, 29–85). The mean adjusted CS was 82% (range, 30–117), active forward flexion 127 degrees and the active abduction 115 degrees. Initial fracture pattern, the presence or absence of adequate medial support and age did not significantly influence the clinical scores. Complications included one infection, two cases of avascular necrosis, two cases of varus collapse with screw penetration and one non-union. The overall reoperation rate was 26%. There was an increased rate of complications in those with inadequate medial support (P = 0.0183) and a trend to higher complication rates in four-part fractures.

Conclusion
Using the locking proximal humerus plate for the treatment of proximal humeral fractures is an acceptable procedure with comparable outcomes with historical controls, but with a complication rate of 30%. More important than implant selection, however, is the ability to achieve a stable reduction with calcar support.
Language eng
DOI 10.1111/ans.12370
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 920116 Skeletal System and Disorders (incl. Arthritis)
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Wiley
Persistent URL http://hdl.handle.net/10536/DRO/DU:30058736

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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