Internal Fixation of Proximal Humerus Fracture with Locking Compression Plate

Abstract

Purpose:We assessed the radiographic and clinical results of one surgeon's experience treating proximal humerus fractures with a locked proximal humeral plate. Materials and Methods: Twenty patients with unstable proximal humerus fractures were treated with a locking compression plate between February 2005 and September 2007. The average age of the patients was 60.6 years, and the average postoperative follow-up period was 22.3 months. The clinical results were evaluated using the Constant and DASH scores. The radiologic results were evaluated by the Paavolainen method, which measures the neck shaft angle and humeral head height. Results: At the last follow-up examination, the mean Constant score was 75.3 and 15 cases (75%) had excellent or good results; the mean DASH score was 16.4. The mean neck shaft angle was 137.1。 , and 19 cases (95%) had good results by the Paavolainen method. There was one delayed union, malunion, and screw loosening. Conclusion:The patients treated with a locking compression plate had relatively good clinical and radiologic results, and a low complication rate. Moreover, the patients could exercise earlier due to good reduction and initial stability. Treatment of unstable proximal humerus fractures with a locking compression plate is a reliable method.

The Analysis of the Treatment Outcomes of Proximal Humeral Fractures with Locking Plates

“…4,[6][7][8] The clinical outcomes were satisfactory even in comminuted fractures or severe osteoporosis. 9,10) Nevertheless, there were some cases of inability to maintain anatomical reduction leading to post-surgical complications such as malunion of fracture.…”

“…[6][7][8] However, treatment using locking plates has been shown to be associated with postoperative complications such as avascular necrosis, intra-articular penetration of the locking screws. 11,17,18) Our study also described a subset of patients with postoperative complications such as intraarticular perforation of locking screws and non-union.…”

Effect of Calcar Screw in Locking Compression Plate System for Osteoporotic Proximal Humerus Fracture: A Finite Element Analysis Study

“…To broaden its application to diverse clinical cases and prove its effectiveness through quantitative analysis, this surgical procedure has been vigorously investigated [9][10][11] with a focus on the design of the LCP and on the appropriate number of screws for preventing bone loss [12][13][14][15][16]. The existing literature shows that placement of a calcar screw in the lower part of the proximal humerus can help achieve safe and stable fixation; using calcar screws particularly make sense in case of a fracture in which there is unstable medial support of the proximal humerus caused by the varus of humeral head.…”