M. Hessmann et al., Plate fixation of proximal humeral fractures with indirect reduction: surgical technique and results utilizing three shoulder scores, INJURY, 30(7), 1999, pp. 453-462
Citations number
24
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
To determine the outcome after indirect reduction and buttress plate fixati
on of displaced and unstable proximal humeral fractures: we retrospectively
evaluated 98 patients, an average of 34 months (range 24-72 months) after
fracture fixation. The patients were reviewed and results were evaluated cl
inically according to the Neer, UCLA and Constant score. A radiographic eva
luation of fracture healing, avascular necrosis and degenerative changes of
the shoulder joint was performed in all patients. Any complications of tre
atment were assessed. Results were, according to the UCLA-rating system, go
od to excellent in 76% of fractures. According to the Constant-score and th
e Neer score, good to excellent results were obtained in 69 and 59% of frac
tures, respectively. Poor results were mainly due to secondary malunion. Th
e avascular necrosis rate was 4%. Non-union was seen in one case. Secondary
varus deformity and retroversion of the humeral head as a result of lack o
f rotational and angular stability of the plate developed in twelve (12%) a
nd eight (8%) cases, respectively. Plate fixation is an adequate procedure
for treating unstable and displaced two- to four-part fractures of the prox
imal humerus, enabling early functional after-treatment. The incidence of a
vascular necrosis and nonunion are low, when fracture reduction is performe
d indirectly. Poor rotational and angular instability can lead to a loss of
reduction. (C) 1999 Elsevier Science Ltd. All rights reserved.