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Published in: International Orthopaedics 6/2010

01-08-2010 | Original Paper

Long-term results after non-plate head-preserving fixation of proximal humeral fractures

Authors: Christian Bahrs, Andreas Badke, Bernd Rolauffs, Kuno Weise, Sebastian Zipplies, Klaus Dietz, Christoph Eingartner

Published in: International Orthopaedics | Issue 6/2010

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Abstract

A retrospective study was conducted to evaluate displaced proximal humeral fractures treated with a non-plate head-preserving fixation and to detect factors predicting functional outcome. After a median follow-up period of 79.7 months, 105 patients with nine A-fractures, 36 B-fractures and 60 C-fractures (nine two-part-fractures, 41 three-part fractures and 55 four-part fractures) were assessed. Functional outcome was measured based on the Constant and UCLA scores. Of all patients, 70–75% had excellent or good Constant and UCLA scores. In 74% a good or satisfactory quality of initial reduction fracture was achieved. About one-fifth (21%) of the fractures showed a secondary displacement. Twenty-seven percent of the patients had signs of humeral head necrosis and 22% had implant related problems. There were significant correlations between a high final score and young age, low AO fracture severity, good quality of fracture reduction and residual osseous deformity, absence of secondary fracture displacement, implant-related complications, shoulder arthrosis and humeral head necrosis at the time of follow-up. In conclusion, the non-plate head-preserving fixation of proximal humeral fractures is an alternative treatment for displaced proximal humeral fractures. Especially in severely displaced C-fractures in older patients, non-anatomical reduction leads to a high rate of secondary displacement, residual osseous deformity and only a fair shoulder function. For these cases alternative methods such as prosthetic replacement should be chosen.
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Metadata
Title
Long-term results after non-plate head-preserving fixation of proximal humeral fractures
Authors
Christian Bahrs
Andreas Badke
Bernd Rolauffs
Kuno Weise
Sebastian Zipplies
Klaus Dietz
Christoph Eingartner
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 6/2010
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-009-0848-4

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