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International Orthopaedics

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01-06-2015 | Original Paper

Comparison between the spatial subchondral support plate and the proximal humeral locking plate in the treatment of unstable proximal humeral fractures

Authors: Fan Zhang, Lei Zhu, Di Yang, Peng Yang, Jun Ma, Qiang Fu, Aimin Chen

Published in: International Orthopaedics | Issue 6/2015

Abstract

Purpose

The aim of our study was to evaluate the effect of the S3 (spatial subchondral support) humeral plate and to compare the clinical outcomes and complications after ORIF (open reduction and internal fixation) of proximal humeral fractures using either a S3 plate or a PHLP (proximal humeral locking plate).

Methods

A total of 144 patients with displaced unstable proximal humeral fractures were treated with either a S3 plate or a PHLP. Each patient had a follow-up at least for one year. We retrospectively collected the data and compared the shoulder functional outcome as well as complications of these two methods.

Results

During the one-year follow-up, the average Constant scores gradually improved for both groups. Patients treated with use of an S3 plate had better functional results at three and six months (P < 0.05). The one-year Constant score for all fracture types (Neer classified) were not significantly different between the S3 and PHLP group (P > 0.05). The complication rate was comparable between the two groups (P > 0.05).

Conclusions

The treatment using an S3 plate for displaced unstable proximal humeral fractures resulted in a good union rate and functional outcome, which is comparable to the PHLP treatment. The S3 humerus plate can be considered as an effective implant for ORIF of displaced unstable proximal humeral fractures.

Konrad G, Hirschmuller A, Audige L, Lambert S, Hertel R, Sudkamp NP (2012) Comparison of two different locking plates for two-, three- and four-part proximal humeral fractures–results of an international multicentre study. Int Orthop 36:1051–1058PubMedCentralPubMedCrossRef

Gille J, Schulz AP, Queitsch C, Paech A, Jurgens C (2008) Initial results of the S3-humerus plate. Open Orthop J 2:133–136PubMedCentralPubMedCrossRef

Bahrs C, Stojicevic T, Blumenstock G, Brorson S, Badke A, Stockle U, Rolauffs B, Freude T (2014) Trends in epidemiology and patho-anatomical pattern of proximal humeral fractures. Int Orthop 38:1697–1704PubMedCrossRef

Palvanen M, Kannus P, Niemi S et al (2006) Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res 442:87–92PubMedCrossRef

Li YC, Zhao LY, Zhu L, Li J, Chen AM (2013) Internal fixation versus nonoperative treatment for displaced 3-part or 4-part proximal humeral fractures in elderly patients: a meta-analysis of randomized controlled trials. PLoS ONE 8:e75464PubMedCentralPubMedCrossRef

Stoddard JE, Pryce D, Potter D et al (2011) Early experience of managing proximal humerus fractures with the S3 plate. Should Elb 3:215–218CrossRef

Duralde XA, Leddy LR (2010) The results of ORIF of displaced unstable proximal humeral fractures using a locking plate. J Shoulder Elb Surg 4:480–488CrossRef

Sun JC, Li YL, Ning GZ et al (2013) Treatment of three-and four-part proximal humeral fractures with locking proximal humerus plate. Eur J Orthop Surg Traumatol 23:699–704PubMedCrossRef

Maier D, Jaeger M, Izadpanah K et al (2014) Proximal humeral fracture treatment in adults. J Bone Joint Surg 96:251–261PubMedCrossRef

10.

Südkamp N, Bayer J, Hepp P et al (2009) Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate results of a prospective, multicenter, observational study. J Bone Joint Surg 91:1320–1328PubMedCrossRef

11.

Huff LR, Taylor PA, Jani J et al (2013) Proximal humeral fracture fixation: a biomechanical comparison of two constructs. J Shoulder Elb Surg 22:129–136CrossRef

12.

Rose DM, Sutter EG, Mears SC et al (2010) Proximal humeral fractures a biomechanical comparison of locking plate constructs in a cadaveric 3-part fracture model. Geriatr Orthop Surg Rehabil 1:73–77PubMedCentralPubMedCrossRef

13.

Neer CS 2nd (1970) Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am 52:1077–1089

14.

Lin T, Xiao B, Ma X et al (2014) Minimally invasive plate osteosynthesis with a locking compression plate is superior to open reduction and internal fixation in the management of the proximal humerus fractures. BMC Musculoskelet Disord 15:206PubMedCentralPubMedCrossRef

15.

Sanders RJ, Thissen LG, Teepen JC et al (2011) Locking plate versus nonsurgical treatment for proximal humeral fractures: better midterm outcome with nonsurgical treatment. J Shoulder Elb Surg 20:1118–1124CrossRef

16.

Constant CR, Murley AG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMed

17.

Clement ND (2013) Can we decipher indications and outcomes of the PHILOS plate for fractures of the proximal humerus? Int Orthop 37:1199–1200PubMedCentralPubMedCrossRef

18.

Zhou ZB, Gao YS, Tang MJ, Sun YQ, Zhang CQ (2013) Reply to: can we decipher the indications and outcome of the PHILOS plate for fractures of the proximal humerus? Int Orthop 37:1201PubMedCentralPubMedCrossRef

19.

Charalambous CP, Siddique I, Valluripalli K et al (2007) Proximal humeral internal locking system (PHILOS) for the treatment of proximal humeral fractures. Arch Orthop Trauma Surg 127:205–210PubMedCrossRef

20.

Koukakis A, Apostolou CD, Taneja T et al (2006) Fixation of proximal humerus fractures using the PHILOS plate: early experience. Clin Orthop Relat Res 442:115–120PubMedCrossRef

21.

Labronici PJ, e Albuquerque RP, Schott V, Pires RE, Belangero WD, Franco JS (2014) Proximal humeral fractures: an understanding of the ideal plate positioning. Int Orthop 38:2191–2195PubMedCrossRef

22.

Yang H, Li Z, Zhou F et al (2011) A prospective clinical study of proximal humerus fractures treated with a locking proximal humerus plate. J Orthop Trauma 25:11–17PubMedCrossRef

23.

Brunner F, Sommer C, Bahrs C et al (2009) Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma 23:163–172PubMedCrossRef

24.

Thanasas C, Kontakis G, Angoules A et al (2009) Treatment of proximal humerus fractures with locking plates: a systematic review. J Shoulder Elb Surg 18:837–844CrossRef

Title: Comparison between the spatial subchondral support plate and the proximal humeral locking plate in the treatment of unstable proximal humeral fractures
Authors: Fan Zhang
Lei Zhu
Di Yang
Peng Yang
Jun Ma
Qiang Fu
Aimin Chen
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 6/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2705-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison between the spatial subchondral support plate and the proximal humeral locking plate in the treatment of unstable proximal humeral fractures

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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