Abstract
Introduction: Regarding operative treatment of proximal humeral fractures no current treatment guidelines have been established so far. Angular stable implant for stabilisation of proximal humerus fractures find increased spreading. Aim of the study was the evaluation of pain, function subjective contentment and especial the surgical complications after stabilization with the Proximal Humerus Plate.
Methods: 214 patients were treated with PHP from 8/2001 to 2/2005 and documented prospectively. The humeral head fragment was fixated with four angular stable self locking screws. Neer–Classification showed 102 2-part, 71 3-part and 41 4-part fractures. Follow up (x-ray, VAS, Constant Score) was performed after 6 and 12 months respectively.
Results: Until now 154 (72%) Patients were available for follow up. Complications were seen in 31 cases (20%). Leading were perforation of self locking screws of the humeral head (10), followed by secondary dislocation (7, 3 of them with re-trauma), secondary humeral head necrosis (6), implant failure (3), malposition (varus) (3), and infection (2). In 18 cases (12%) re-operation was necessary: removal of screws (7), re-osteosynthesis (6), hemiarthroplasty (5). The constant score (compared to uninjured side) was 6 months postoperatively 61 (71%) and after 12 months 73 (82%).
Conclusion: The problems of osteosynthesis of proximal humeral fractures using an internal fixator are shown by the complications. Especially rigid self locking head screws show a high risk to perforate the humeral articular surface. On the other hand results showed good primary and secondary stability in comparison with the literature.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
