Skip to main content

Advertisement

SpringerLink
Log in

Treatment of three- and four-part proximal humeral fractures with locking proximal humerus plate

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objective

The purpose of this study was to evaluate the effectiveness and complications of the locking proximal humerus plate to treat proximal humerus fractures.

Design

A retrospective clinical trial.

Setting

Department of Orthopaedics, Tianjin Medical University General Hospital.

Patients

Sixty-eight consecutive patients with three- or four-part fractures of the proximal humerus were treated with locking proximal humerus plates.

Intervention

The deltopectoral anterolateral acromial approach was used to the proximal humerus; open reduction and locking proximal humerus plate were applied.

Main outcome measurements

Constant Score was used to measure the shoulder functional recovery, and Visual Analog Scale (VAS) was used to measure subjective evaluation of pain. The radiology was observed.

Results

After average 26.7 months, the average Constant Score was 72.6 ± 13.2 points and the average VAS was 1.2 ± 0.8 points. All the complications such as screw perforation into the glenohumeral joint, screws loosening, soft tissue infections, avascular necrosis and delayed union occurred in eight cases (11.8 %).

Conclusions

The effectiveness of the locking proximal humerus plate was similar to other published literatures on treating fractures of the proximal humerus; however, a lower complications rate in short follow-up time was observed in this study. It may potentially provide a favorable option for treating three- or four-part fractures of the proximal humerus. Dealing with each particular fracture pattern, surgeons should have a decision of appropriate way to internal fixation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Court-Brown CM, Garg A, McQueen MM (2001) The epidemiology of proximal humeral fractures. Acta Orthop Scand 72:365–371

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  3. Ring D (2007) Current concepts in plate and screw fixation of osteoporotic proximal humerus fractures. Injury 38(Suppl 3):S59–S68

    Article  PubMed  Google Scholar 

  4. Karataglis D, Stavridis SI, Petsatodis G, Papadopoulos P, Christodoulou A (2011) New trends in fixation of proximal humeral fractures: a review. Injury 42(4):330–338

    Article  PubMed  Google Scholar 

  5. Konrad G, Bayer J, Hepp P, Voigt C, Oestern H, Kääb M, Luo C, Plecko M, Wendt K, Köstler W, Südkamp N (2010) Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate Surgical technique. J Bone Joint Surg Am 92(Suppl 1 Pt 1):85–95

    PubMed  Google Scholar 

  6. Agel J, Jones CB, Sanzone AG, Camuso M, Henley MB (2004) Treatment of proximal humeral fractures with Polarus nail fixation. J Should Elbow Surg 13(2):191–195

    Article  Google Scholar 

  7. Smith J, Berry G, Laflamme Y, Blain-Pare E, Reindl R, Harvey E (2007) Percutaneous insertion of a proximal humeral locking plate: an anatomic study. Injury 38(2):206–211

    Article  PubMed  Google Scholar 

  8. Cadet ER, Ahmad CS (2012) Hemiarthroplasty for three- and four-part proximal humerus fractures. J Am Acad Orthop Surg 20(1):17–27

    Article  PubMed  Google Scholar 

  9. Duralde XA, Leddy LR (2010) The results of ORIF of displaced unstable proximal humeral fractures using a locking plate. J Should Elbow Surg 19(4):480–488

    Article  Google Scholar 

  10. Sproul RC, Iyengar JJ, Devcic Z, Feeley BT (2011) A systematic review of locking plate fixation of proximal humerus fractures. Care Inj 42:408–413

    Article  Google Scholar 

  11. Yang H, Li Z, Zhou F, Wang D, Zhong B (2011) A prospective clinical study of proximal humerus fractures treated with a locking proximal humerus plate. J Orthop Trauma 25(1):11–17

    Article  PubMed  Google Scholar 

  12. Barrett JA, Baron JA, Karagas MR, Beach ML, Fracture risk in the U.S. (1999) Medicare population. J Clin Epidemiol 52(3):243–249

    Article  PubMed  CAS  Google Scholar 

  13. Ring D (2007) Current concepts in plate and screw fixation of osteoporotic proximal humerus fractures. Care Inj 38:59–68

    Article  Google Scholar 

  14. Bell JE, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, Tosteson AN (2011) Trends and variation in incidence, surgical treatment, and repeat surgery of proximal humeral fractures in the elderly. J Bone Joint Surg 93:121–131

    Article  PubMed  Google Scholar 

  15. Siffri PC, Peindl RD, Coley ER, Norton J, Connor PM, Kellam JF (2006) Biomechanical analysis of blade plate versus locking plate fixation for a proximal humerus fracture: comparison using cadaveric and synthetic humeri. Orthop Trauma 20(8):547–554

    Google Scholar 

  16. Gardner MJ, Weil Y, Barker JU, Kelly BT, Helfet DL, Lorich DG (2007) The importance of medial support in locked plating of proximal humerus fractures. Orthop Trauma 21(3):185–191

    Google Scholar 

  17. Clavert P, Adam P, Bevort A, Bonnomet F, Kempf JF (2010) Pitfalls and complications with locking plate for proximal humerus fracture. J Should Elbow Surg 19(4):489–494

    Article  Google Scholar 

  18. Südkamp N, Bayer J, Hepp P, Voigt C, Oestern H, Kääb M, Luo C, Plecko M, Wendt K, Köstler W, Konrad G (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 Am 91:1320–1328

    Article  PubMed  Google Scholar 

  19. Röderer G, Erhardt J, Graf M, Kinzl L, Gebhard F (2010) Clinical results for minimally invasive locked plating of proximal humerus fractures. Orthop Trauma 24(7):400–406

    Google Scholar 

  20. Narvani Ali, Levy Ofer (2010) Minimal invasive flexible fixation for fractures of the proximal humerus. Ann R Coll Surg Engl 92(8):635–638

    PubMed  Google Scholar 

  21. Antuña SA, Sperling JW, Cofield RH (2008) Shoulder hemiarthroplasty for acute fractures of the proximal humerus: a minimum five-year follow-up. J Should Elbow Surg 17(2):202–209

    Article  Google Scholar 

  22. Castricini R, De Benedetto M, Pirani P, Panfoli N, Pace N (2011) Shoulder hemiarthroplasty for fractures of the proximal humerus. Musculoskelet Surg 95(1):49–54

    Article  Google Scholar 

  23. Huguet D, DeClercq G, Rio B, Teissier J, Zipoli B; TESS Group (2010) Results of a new stemless shoulder prosthesis: radiologic proof of maintained fixation and stability after a minimum of three years’ follow-up. Should Elbow Surg 19:847–852

    Article  Google Scholar 

  24. den Hartog D, de Haan J, Schep NW, Wim E, Tuinebreijer WE (2010) Primary shoulder arthroplasty versus conservative treatment for comminuted proximal humeral fractures: a systematic literature review. Open Orthop J 4:87–92

    Google Scholar 

  25. Zhu Yiming, Yi Lu, Wang M, Jiang C (2010) Treatment of proximal humeral fracture with a proximal humeral nail. Should Elbow Surg 19:297–302

    Article  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of China

    Jing-Cheng Sun, Yu-Lin Li, Guang-Zhi Ning, Qiang Wu & Shi-Qing Feng

Authors
  1. Jing-Cheng Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yu-Lin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guang-Zhi Ning
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Qiang Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shi-Qing Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shi-Qing Feng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sun, JC., Li, YL., Ning, GZ. et al. Treatment of three- and four-part proximal humeral fractures with locking proximal humerus plate. Eur J Orthop Surg Traumatol 23, 699–704 (2013). https://doi.org/10.1007/s00590-012-1040-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-012-1040-x

Keywords

Search

Navigation