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VOLUME 2 , ISSUE 1 ( January-March, 2016 ) > List of Articles

RESEARCH ARTICLE

Functional Outcome of Locking Compression Plate in Neer's two-part, three-part, four-part Proximal Humerus Fractures

KV Ramesh, G Mahesh, KC Kiran, Roshan Kumar

DOI: 10.5005/jp-journals-10045-0024

License: NA

Published Online: 01-06-2016

Copyright Statement:  NA


Abstract

Introduction

Proximal fractures of the humerus account for about 4 to 5% of all fractures. They are the most common fractures in elderly population. Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains challenging.

Objectives

The present study is undertaken to evaluate the functional outcome of proximal humerus fractures treated by locking compression plate in 20 patients.

Materials and methods

Prospective study was done involving 20 adult patients with proximal humerus fractures admitted from October 2012 to December 2013 treated by open reduction and internal fixation (ORIF) with locking compression plate. The functional follow-up was done for a minimum period of 3 months and the patients were evaluated by Constant Murley scoring (CMS).

Results

In our series, the majority of the patients were middle-aged males, with road traffic accidents (RTAs) being the most common cause of injury, involving 2-part, 3-part, and 4-part fractures of the proximal humerus. The fractures were united in 19 patients and 1 patient had avascular necrosis (AVN). Excellent results were seen in 15% of patients, good results in 55%, moderate results in 15%, and poor results in 15% according to CMS. There were 95% union rates, 5% of AVN, and no failures.

Conclusion

In conclusion, locking compression plate is an advantageous implant in proximal humerus fractures due to angular stability, particularly in comminuted fractures and in osteoporotic bones of elderly patients, which allows their early mobilization.

How to cite this article

Mahesh G, Kiran KC, Ramesh KV, Kumar R. Functional Outcome of Locking Compression Plate in Neer's two-part, three-part, four-part Proximal Humerus Fractures. J Med Sci 2016;2(1):1-8.


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  1. New trends in treatment of proximal humerus fractures. Clin Orthop Relat Res 2006 Jan;442: 100-108.
  2. The epidemiology of peripheral fractures. Bone 1996 Mar;18(Suppl 3):209S-213S.
  3. Epidemiology of adult fractures. Injury 2006 Aug;37(8:)691-697.
  4. Non-operative treatment of comminuted fractures of the proximal humerus in elderly patients. Injury 1998 Jun;29(5:)349-352.
  5. Open reduction and internal fixation of three and four-part fractures of the proximal humerus. J Bone Joint Surg Am 2002 Nov;84(11:)1920-1925.
  6. Open reduction and internal fixation of proximal humerus fractures with the use of the locking proximal humerus plate. J Bone Joint Surg Am 2009 Jun;91(6:)1320-1328.
  7. Open reduction and internal fixation of proximal humerus fractures using proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma 2009 Mar;23(3:)163-172.
  8. Internal fixation of proximal humeral fractures with a locking compression plate. Acta Orthop Scand 2004 Dec;75(6:)741-745.
  9. Analysis of efficacy and failure in proximal humerus fractures treated with locking plates. J Orthop Trauma 2007 Nov-Dec;21(10:)676-681.
  10. Osteosynthesis and hemiarthroplasty of fractures of the proximal humerus: outcomes in a consecutive case series. J Shoulder Elbow Surg 2009 Mar-Apr;18(2:)216-219.
  11. Locked plating of 3- and 4-part proximal humerus fractures in older patients: The effect of initial fracture pattern on outcome. J Orthop Trauma 2009 Feb;23(2:)113-119.
  12. Four part fractures of the proximal humerus. J Orthop Trauma 2004 Feb;18(2:)126-127.
  13. Fractures of the upper of the humerus. Clin Orthop 1971;20:73-93.
  14. Fractures and dislocations of the shoulder. In: Rockwood, C.A.; Green, D.P., editors. Fracture in adults. Philadelphia, PA: Lippincott; 1984. p. 675-721.
  15. Two-part and three part fractures management of proximal and distal humerus fracture. Orthop Clin North Am 2000 Jan;31(1:)1-21.
  16. ; Chandler, Robert W. Fractures of the proximal humerus. In: Jobe, Frank W., editor. Operative techniques in upper extremity sports injuries. St. Louis, MO: Mosby; 1995. p. 313-340.
  17. Non-operative treatment of comminuted fracture of proximal humerus in elderly patients. Injury 1998 Jun;29(5:)349-352.
  18. Angular-stable locked intramedullary nailing of two-part surgical neck fractures of the proximal part of the humerus. A multicenter retrospective observational study. J Bone Joint Surg Am 2011 Dec;93(23:)2172-2179.
  19. Plate fixation of proximal humerus fracture with indirect reduction; Surgical technique and results using the shoulder score. Injury 1999 Sep;30(7:)453-462.
  20. Rigid internal fixation of fractures of the proximal humerus in older patients. J Bone Joint Surg Br 2000 Nov;82(8:)1107-1112.
  21. Internal fixation of complex fractures of the proximal humerus. J Bone Joint Surg Br 2004 Aug;86(60:)848-855.
  22. Proximal humerus internal locking for the treatment of proximal humerus fracture. Arch Orthop Trauma Surg 2007 Apr;127(3:)205-210.
  23. Plating in proximal humeral fractures. Eur J Trauma Emerg Surg 2007 Aug:33(4:)345-356.
  24. Displaced proximal humeral fractures: an Indian experience with locking plate. J Orthop Surg Res 2010 Aug;5:60.
  25. Internal fixation of proximal humerus fracture by locking proximal humerus plate in elderly osteoporotic. J Orthop Traumatol 2008 Sep;9(3:)149-153.
  26. Fracture displacement and screw cutout after open reduction and locked plate fixation of proximal humeral fracture. J Bone Joint Surg Am 2008 Feb;90(2:)233-240.
  27. Fixation of proximal humerus fractures using the PHILOS plate. Clin Orthop Relat Res 2006 Jan;442:115-120.
  28. Clinical and radiological evaluation of minimally displaced proximal humeral fractures. Arch Orthop Trauma Surg 2010 May;130(5:)673-679.
  29. Development of an upper extremity outcome measure: The DASH (Disabilities of the Arm, Shoulder, and Hand). The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996 Jun;29(6:)602-608.
  30. Open reduction and fixation of proximal humeral fractures and fracture dislocations. J Bone Joint Surg Br 1990 Nov;72(6:)1050-1052.
  31. Proximal humeral fractures: Management techniques and expected results. Clin Orthop Relat Res 1993 Jul;293:13-25.
  32. Early results for treatment of three- and four-part fractures of the proximal humerus G Mahesh et al using the PHILOS plate system. J Bone Joint Surg Br 2007 Sep;89(9:)1206-1209.
  33. Functional follow-up of locking plate fixation of fractures of the proximal humerus. Eur J Orthop Surg Traumatol 2008 Feb;18(2:)87-92.
  34. PHILOS plate fixation for displaced proximal humeral fractures. J Orthop Surg (Hong Kong) 2009 Apr;17(1:)15-18.
  35. Percutaneous fixation of three and four part fractures of proximal humerus. J Bone Joint Surg Br 1997 Mar;79(2:)295-300.
  36. Proximal humerus locking plate for proximal humerus fracture – Retrospective study. J Orthop Surg 2009;17(1):10-14.
  37. Johar M, Evaluation of Different Modalities of Osteosynthesis of Proximal Humerus Fractures in Adults. Ind J Orth Surg 2016;2(1):27-34.
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