Deakin University
Browse

File(s) under permanent embargo

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

journal contribution
posted on 2013-11-01, 00:00 authored by P Pak, K Eng, Richard PageRichard Page
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.

History

Journal

ANZ journal of surgery

Volume

83

Issue

11

Pagination

878 - 882

Publisher

Wiley-Blackwell Publishing Asia

Location

Melbourne, Vic.

ISSN

1445-1433

eISSN

1445-2197

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2013, Wiley