THE NORTHWEST EXPERIENCE OF USING THE “PLANTTAN” PLATE FOR INTERNAL FIXATION OF PROXIMAL HUMERAL FRACTURES – THE FIRST 12 MONTHS

Abstract

Aims: To assess shoulder function and pain following open reduction and internal fixation of displaced 2, 3 & 4 part fractures of the proximal humerus, using a new fixation plate designed to provide rotation and angle stability.

Method: Patients treated by open reduction and internal fixation with a PlantTan Plate (PTP) were followed-up for a minimum period of 12 months from time of surgery. Post-operatively Constant-Murley (CMS) and visual analogue (VAS) scoring systems were used to assess function and pain at 2, 6 and 12 months post-operatively. Complications have been recorded.

Results: 48 patients have been treated by 4 surgeons with a PTP. Mean patient age was 65 (32 – 89), 17 male, 31 female. Six operations were undertaken for non-union and 42 for acute fractures. At 12 months the mean CMS was 70 (19 – 95) for the fractured side compared to 86 (75 – 100) for the uninjured side, with a mean VAS of 20 (0–68). Six patients have died (unrelated causes). Screws have cut out in 6 (12.5%) patients with 1 requiring implant removal, 1 requiring revision and 1 requiring removal of a head screw. One screw cut out was due to the only case of AVN to date. There have been 5 (10.4%) superficial wound infections (resolved with oral antibiotics) and no deep infections. One patient had a postoperative CVA and one case developed a compartment syndrome due to intra-operative vascular injury; treated successfully with fasciotomies and vascular repair.

Conclusion: We believe the PTP is a useful implant for the management of displaced proximal humeral fractures. We will report on a minimum 2 year follow-up in the near future.